title: Prevalence of drug-resistance mutations and non-subtype B strains among HIV-infected infants from New York State.
abstract: Prevalence studies indicate that transmission of drug-resistant HIV has been rising in the adult population, but data from the perinatally infected pediatric population are limited. In this retrospective study, we sequenced the pol region of HIV from perinatally infected infants diagnosed in New York State in 2001-2002. Analyses of drug resistance, subtype diversity, and perinatal antiretroviral exposure were conducted, and the results were compared with those from a previous study of HIV-infected infants identified in 1998-1999. Eight of 42 infants (19.1%) had provirus carrying at least 1 drug-resistance mutation, an increase of 58% over the 1998-1999 results. Mutations conferring resistance to nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors, and protease inhibitors were detected in 7.1%, 11.9%, and 2.4% of specimens, respectively. Consistent with previous results, perinatal antiretroviral exposure was not associated with drug resistance (P = 0.70). Phylogenetic analysis indicated that 16.7% of infants were infected with a non-subtype B strain of HIV. It seems that drug-resistant and non-subtype B strains of HIV are becoming increasingly common in the perinatally infected population. Our results highlight the value of resistance testing for all HIV-infected infants upon diagnosis and the need to consider subtype diversity in diagnostic and treatment strategies.
authors.affiliation: Wadsworth Center, New York State Department of Health, Albany, NY 12201-2002, USA.
authors.forename: Marine
authors.initials: M
authors.lastname: Karchava
authors.forename: Wendy
authors.initials: W
authors.lastname: Pulver
authors.forename: Lou
authors.initials: L
authors.lastname: Smith
authors.forename: Sean
authors.initials: S
authors.lastname: Philpott
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Sullivan
authors.forename: Judith
authors.initials: J
authors.lastname: Wethers
authors.forename: Monica M
authors.initials: MM
authors.lastname: Parker
mesh_terms: D019380:Anti-HIV Agents / Q000494:pharmacology* / Q000627:therapeutic use; D016000:Cluster Analysis; D004252:DNA Mutational Analysis; D024882:Drug Resistance, Viral / Q000235:genetics; D005260:Female; D016679:Genome, Viral; D005838:Genotype; D006678:HIV / Q000145:classification / Q000187:drug effects* / Q000235:genetics*; D015658:HIV Infections / Q000188:drug therapy / Q000635:transmission / Q000821:virology*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D009154:Mutation; D009518:New York; D010802:Phylogeny; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000821:virology; D012367:RNA, Viral / Q000235:genetics; D012189:Retrospective Studies; D017422:Sequence Analysis, DNA; D017385:Sequence Homology; D013223:Statistics as Topic
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral