title: Resistance detected by pyrosequencing following zidovudine monotherapy for prevention of HIV-1 mother-to-child-transmission.
abstract: To prevent mother-to-child-transmission of HIV-1, the 2010 WHO guidelines recommended prenatal zidovudine (ZDV) monotherapy (option A). To determine if ZDV monotherapy selects for HIV resistance in antiretroviral-naive women during pregnancy, specimens from 50 individuals were examined using pyrosequencing. ZDV-resistance mutations were detected at delivery in seven women (14%, 95% confidence interval 6.6-26.5%). These data raise the question whether women administered ZDV monotherapy for prevention of mother-to-child-transmission could have higher risk of virologic failure when later started on combination antiretroviral therapy, as has been demonstrated following single-dose nevirapine prophylaxis.
authors.affiliation: aUniversity of Washington bSeattle Children's Research Institute, Seattle, Washington, USA cInstitut de Recherche pour le Développement (IRD) UMI 174-PHPT, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand dHarvard School of Public Health, Boston, Massachusetts eTulane University School of Medicine, New Orleans, Louisiana, USA.
authors.forename: Scott C
authors.initials: SC
authors.lastname: Olson
authors.forename: Nicole
authors.initials: N
authors.lastname: Ngo-Giang-Huong
authors.forename: Ingrid
authors.initials: I
authors.lastname: Beck
authors.forename: Wenjie
authors.initials: W
authors.lastname: Deng
authors.forename: Paula
authors.initials: P
authors.lastname: Britto
authors.forename: David E
authors.initials: DE
authors.lastname: Shapiro
authors.forename: Roger E
authors.initials: RE
authors.lastname: Bumgarner
authors.forename: James I
authors.initials: JI
authors.lastname: Mullins
authors.forename: Russell B
authors.initials: RB
authors.lastname: Van Dyke
authors.forename: Gonzague
authors.initials: G
authors.lastname: Jourdain
authors.forename: Lisa M
authors.initials: LM
authors.lastname: Frenkel
mesh_terms: D000328:Adult; D019943:Amino Acid Substitution; D019380:Anti-HIV Agents / Q000008:administration & dosage*; D018890:Chemoprevention / Q000379:methods; D024882:Drug Resistance, Viral; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy / Q000517:prevention & control / Q000635:transmission / Q000821:virology*; D054303:HIV Reverse Transcriptase / Q000235:genetics; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D020125:Mutation, Missense; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000188:drug therapy / Q000821:virology*; D012367:RNA, Viral / Q000235:genetics; D017422:Sequence Analysis, DNA; D055815:Young Adult; D015215:Zidovudine / Q000008:administration & dosage*
chemical_list: D019380:Anti-HIV Agents; D012367:RNA, Viral; D015215:Zidovudine; C514824:reverse transcriptase, Human immunodeficiency virus 1; D054303:HIV Reverse Transcriptase