A post-partum single-dose TDF/FTC tail does not prevent the selection of NNRTI resistance in women receiving pre-partum ZDV and intrapartum single-dose nevirapine to prevent mother-to- child HIV-1 transmission.
Although the rates of vertical transmission of HIV in the developing world have improved to around 3% in countries like South Africa, resistance to antiretrovirals (ARV) used in Prevention of Mother-to-Child transmission (pMTCT) strategies may thwart such outcomes and affect the efficacy of future ARV regimens in mothers and children. This study conducted in Durban, South Africa, between 2010 and 2013 found a high rate of nevirapine (NVP) resistance among women receiving Zidovudine (AZT) from 14 weeks gestation, single dose nevirapine (sd NVP) at the onset of labor and a single dose of coformulated Tenofovir/Emtricitabine (TDF/FTC) postpartum. Using Sanger sequencing, high and intermediate levels of nevirapine (NVP) resistance were detected in 15/44 (34%) and in 1/44 (2%) of women tested, respectively. Most subjects selected the K103N mutation (22% (10/45) of all patients and 66% (10/15) of those with high-level NVP resistance). Such rate of NVP resistance is comparable to studies where only sd NVP was used. In conclusion, a post-partum single-dose TDF/FTC tail does not prevent the selection of NNRTI resistance in women receiving pre-partum ZDV and intrapartum sd NVP to prevent mother-to-child HIV-1 transmission.
Department of Virology, National Health Laboratory Service, University of KwaZulu-Natal, Durban, South Africa.
Reshmi
R
Samuel
irsiCaixa AIDS Research Institute, Badalona, Catalonia, Spain.|HIV Unit, Hospital Universitari Germans Trias i Pujol, Badalona, Catalonia, Spain.|Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain.|Universitat de Vic, Vic, Catalonia, Spain.
Roger
R
Paredes
Department of Virology, National Health Laboratory Service, University of KwaZulu-Natal, Durban, South Africa.
Raveen
R
Parboosing
Department of Virology, National Health Laboratory Service, University of KwaZulu-Natal, Durban, South Africa.
Pravi
P
Moodley
Department of Virology, National Health Laboratory Service, University of KwaZulu-Natal, Durban, South Africa.
Lavanya
L
Singh
Department of Virology, National Health Laboratory Service, University of KwaZulu-Natal, Durban, South Africa.
Anneta
A
Naidoo
Department of Virology, HIV Pathogenesis Laboratory, Nelson R Mandela Medical School, University of KwaZulu-Natal, Durban, South Africa.
Michelle
M
Gordon
D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D023241:Antiretroviral Therapy, Highly Active; D002648:Child; D003841:Deoxycytidine / Q000008:administration & dosage* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D024882:Drug Resistance, Viral; D000068679:Emtricitabine / Q000008:administration & dosage* / Q000627:therapeutic use; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control / Q000635:transmission* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics / Q000472:pathogenicity; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control* / Q000706:statistics & numerical data; D009035:Mothers; D009154:Mutation / Q000187:drug effects; D019829:Nevirapine / Q000008:administration & dosage / Q000627:therapeutic use; D049590:Postpartum Period; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000517:prevention & control / Q000821:virology; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D017422:Sequence Analysis, DNA; D013019:South Africa; D000068698:Tenofovir / Q000008:administration & dosage* / Q000627:therapeutic use; D019562:Viral Load; D015215:Zidovudine / Q000008:administration & dosage*
D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D003841:Deoxycytidine; D015215:Zidovudine; D019829:Nevirapine; D000068698:Tenofovir; D000068679:Emtricitabine
HIV drug resistance; vertical transmission