Resistance mutations in HIV-1 infected pregnant women and their infants receiving antiretrovirals to prevent HIV-1 vertical transmission in China.
The objective of this study was to assess the resistance baseline in HIV-1-infected pregnant women in China and the emergence of drug resistance (DR) among them and their infants after receiving single-dose nevirapine (sdNVP) or zidovudine plus sdNVP (ZDV-sdNVP) for the prevention of mother-to-child transmission (PMTCT). The prospective study followed 62 drug-naïve HIV-1-infected mothers and their infants who received sdNVP for PMTCT and 18 who received ZDV-sdNVP. Primary DR was detected in 8.8% (7/80) of pregnant women at baseline. Two (2.5%) women had mutations associated with nucleoside reverse transcriptase inhibitors (NRTI). Six (7.5%) women harboured mutations associated with non-nucleoside reverse transcriptase inhibitors (NNRTI). No protease inhibitor (PI) DR was detected. The DR rates in infected mothers selected by sdNVP and ZDV-sdNVP regimen were 16.3% and 0%, respectively. Women with the emergence of DR after sdNVP had lower CD4 cell counts at delivery than women without DR after sdNVP (178 vs.364 cells/mm(3), P < 0.05). The vertical transmission rate in women with baseline resistance was similar to that in women without baseline resistance (1/7 vs. 3/73, P > 0.05). The study indicates that NVP resistance after sdNVP was associated with CD4 cell count at delivery. ZDV-sdNVP regimen was of more significance in the prevention of the emergence of NNRTI-related DR than sdNVP.
Han
J
J
National AIDS Reference Laboratory, National Center for AIDS/STD Control and Prevention, China Center for Disease Control and Prevention, 27 Nanwei Road, Beijing 100050, People's Republic of China.
Wang
L
L
Jiang
Y
Y
Zhang
Q
Q
Fang
L
L
Yao
J
J
Wang
Q
Q
D000328:Adult; D018791:CD4 Lymphocyte Count; D002681:China; D015331:Cohort Studies; D024882:Drug Resistance, Viral / Q000235:genetics*; D004359:Drug Therapy, Combination; D005260:Female; D015658:HIV Infections / Q000517:prevention & control / Q000635:transmission / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics*; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D009154:Mutation; D019829:Nevirapine / Q000627:therapeutic use; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control / Q000821:virology*; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D015215:Zidovudine / Q000627:therapeutic use
D018894:Reverse Transcriptase Inhibitors; D015215:Zidovudine; D019829:Nevirapine