title: Prevalence of nevirapine-associated resistance mutations after single dose prophylactic treatment among antenatal clinic attendees in north rift Kenya.
abstract: The use of single dose nevirapine to prevent mother-to-child transmission of HIV has been reported to induce drug-resistant mutations and reduce options for antiretroviral treatment for HIV-infected mothers and their children. To explore the status of nevirapine-resistant HIV genotypes in rural hospitals in the North Rift Valley Province of Kenya, samples collected 3 months after single dose nevirapine from 36 mothers and their children were analyzed. Resistance mutations were genotypically evaluated through proviral DNA amplification, cloning, and sequencing. Ten mothers (27.8%) had antiretroviral-associated resistance mutations of whom four (11.1%) had specific nevirapine (NNRTI) resistance-associated mutations. Three mothers (8.3%) transmitted the infection to their infants. This presence of nevirapine mutations in rural antenatal clinic attendees confirms the importance of integrating antiretroviral resistance monitoring as a key component in programs geared to prevention of HIV mother-to-child transmission.
authors.affiliation: Centre for Virus Research, Kenya Medical Research Institute, Nairobi, Kenya.
authors.forename: Michael
authors.initials: M
authors.lastname: Kiptoo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ichimura
authors.forename: Raphael L
authors.initials: RL
authors.lastname: Wembe
authors.forename: Zipporah
authors.initials: Z
authors.lastname: Ng'Ang'a
authors.forename: Jones
authors.initials: J
authors.lastname: Mueke
authors.forename: Joyceline
authors.initials: J
authors.lastname: Kinyua
authors.forename: Nancy
authors.initials: N
authors.lastname: Lagat
authors.forename: Fredrick
authors.initials: F
authors.lastname: Okoth
authors.forename: E M
authors.initials: EM
authors.lastname: Songok
mesh_terms: D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018890:Chemoprevention / Q000379:methods*; D004279:DNA, Viral / Q000737:chemistry / Q000235:genetics; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000517:prevention & control* / Q000821:virology*; D054303:HIV Reverse Transcriptase / Q000235:genetics*; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D007630:Kenya; D008969:Molecular Sequence Data; D020125:Mutation, Missense; D019829:Nevirapine / Q000627:therapeutic use*; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D011533:Proviruses / Q000235:genetics; D017422:Sequence Analysis, DNA; D017385:Sequence Homology
chemical_list: D019380:Anti-HIV Agents; D004279:DNA, Viral; D019829:Nevirapine; D054303:HIV Reverse Transcriptase