Low Risk of Nevirapine Resistance Mutations in the Prevention of Mother-to-Child Transmission of HIV-1: Agence Nationale de Recherches sur le SIDA Ditrame Plus, Abidjan, Côte d'Ivoire

• Published in: The Journal of infectious diseases 2006-02, Vol.193 (4), p.482-487
• Main Authors: Chaix, Marie-Laure, Ekouevi Didier, Koumavi, Rouet, François, Tonwe-Gold, Besigin, Viho, Ida, Bequet, Laurence, Peytavin, Gilles, Toure, Hassane, Menan, Hervé, Leroy, Valériane, Dabis, Francois, Rouzioux, Christine
• Format: Article
• Language: English
• Subjects: Antiretrovirals; Biological and medical sciences; Cote d'Ivoire; Disease transmission; Drug Resistance, Viral - genetics; Drug Therapy, Combination; Female; Fundamental and applied biological sciences. Psychology; Genetic mutation; Highly active antiretroviral therapy; HIV 1; HIV Infections - prevention & control; HIV Infections - transmission; HIV Infections - virology; HIV/AIDS; Human immunodeficiency virus 1; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical - prevention & control; Infectious diseases; Lamivudine - therapeutic use; Medical sciences; Microbiology; Miscellaneous; Mothers; Mutation; Nevirapine - therapeutic use; Perinatal Care - methods; Pregnancy; Pregnancy Complications, Infectious; Reverse Transcriptase Inhibitors - therapeutic use; RNA; T lymphocytes; Viral Load; Virology; Viruses; Women; Zidovudine - therapeutic use
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/499966

The frequency of resistance mutations was estimated in the cohort of Agence Nationale de Recherches sur le SIDA Ditrame Plus, a study that evaluated the combination of shortcourse zidovudine (ZDV) plus lamivudine (3TC) and singledose nevirapine (SD-NVP) followed by 3 days of postpartum ZDV plus 3TC for the prevention of mother-to-child transmission of human immunodeficiency virus type 1 (HIV-1). The frequency with which resistance mutations were detected in mothers at week 4 postpartum was 1.14% (95% confidence interval [CI], 0.03%–6.17%) for NVP and 8.33% (95% CI, 3.66%–15.76%) for 3TC. In multivariate analysis, 3Te resistance was associated with a longer duration of ZDV plus 3TC prepartum prophylaxis (P = .009). This regimen, which is feasible in resource-limited settings, prevents most peripartum HIV-1 transmission and minimizes the development of NVP resistance.