title: Emergence of HIV-1 drug-resistant variants in women following antiretroviral prophylaxis for the prevention of mother to child transmission.
abstract: OBJECTIVE
  Emergence of drug resistance following HIV prophylaxis has an important impact on ART program.
  
  
  OBJECTIVE
  To investigate the emergence of drug resistance in HIV-1 infected pregnant women.
  
  
  METHODS
  Fifty-three HIV-1 infected pregnant women who had received 4-12 weeks of antenatal AZT followed by Nevirapine during delivery and Combivir [AZT + 3TC] for 1 week postpartum (group-1, n = 48) or who come at the time of delivery and received Nevirapine followed by Combivir for 1 week (group-2, n = 5) were recruited. Samples were collected prior to the start of the prophylaxis and 5-8 weeks postpartum. In addition, a third sample was collected between 26-65 weeks postpartum from 7 women. Amplification of HIV-1 pol gene and drug resistance analysis was done.
  
  
  RESULTS
  Two (3.8%) women in group-1 showed transmitted drug resistance and they continued to show this even at 6 weeks postpartum. One (2%) woman from group-1 showed a mutation after 6-8 weeks of prophylaxis. Among the samples collected between 26-65 weeks postpartum, 3/7 (43%) showed mutations and all these women belong to group-1. Women belonging to group-2 didn't show mutation prior to or following prophylaxis.
  
  
  CONCLUSIONS
  In contrast to the available data among pregnant women with ART prophylaxis, our data showed reduced frequency of mutations following 5-8 weeks of postpartum but an emergence of mutation later (26-65 weeks). The addition of Combivir with the single dose Nevirapine during delivery and the early stage of the disease with higher CD4 counts could be the reasons for this.
authors: M
authors: M
authors: Mani
authors: V V
authors: VV
authors: Ramalingam
authors: J
authors: J
authors: Lionel
authors: S A
authors: SA
authors: Christina
authors: J
authors: J
authors: Sachithanandham
authors: A
authors: A
authors: Peedicayil
authors: Department of Clinical Virology, Christian Medical College, Vellore, Tamil Nadu, India.
authors: R
authors: R
authors: Kannangai
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D018890:Chemoprevention / Q000009:adverse effects / Q000379:methods*; D004338:Drug Combinations; D024882:Drug Resistance, Viral; D005260:Female; D005838:Genotype; D060005:Genotyping Techniques; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control / Q000635:transmission / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects* / Q000302:isolation & purification; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D019259:Lamivudine / Q000494:pharmacology / Q000627:therapeutic use; D019829:Nevirapine / Q000494:pharmacology / Q000627:therapeutic use; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000821:virology*; D055815:Young Adult; D015215:Zidovudine / Q000494:pharmacology / Q000627:therapeutic use; D054302:pol Gene Products, Human Immunodeficiency Virus / Q000235:genetics
chemical_list: D044966:Anti-Retroviral Agents; D004338:Drug Combinations; C109078:lamivudine, zidovudine drug combination; D054302:pol Gene Products, Human Immunodeficiency Virus; D019259:Lamivudine; D015215:Zidovudine; D019829:Nevirapine