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.
['Samuel|Reshmi|R|', 'Paredes|Roger|R|', 'Parboosing|Raveen|R|', 'Moodley|Pravi|P|', 'Singh|Lavanya|L|', 'Naidoo|Anneta|A|', 'Gordon|Michelle|M|']
D000328:Adult D019380:Anti-HIV Agents D023241:Antiretroviral Therapy, Highly Active D002648:Child D003841:Deoxycytidine D004334:Drug Administration Schedule D024882:Drug Resistance, Viral D000068679:Emtricitabine D005260:Female D015658:HIV Infections D015497:HIV-1 D006801:Humans D018445:Infectious Disease Transmission, Vertical D009035:Mothers D009154:Mutation D019829:Nevirapine D049590:Postpartum Period D011247:Pregnancy D011251:Pregnancy Complications, Infectious D018894:Reverse Transcriptase Inhibitors D017422:Sequence Analysis, DNA D013019:South Africa D000068698:Tenofovir D019562:Viral Load D015215:Zidovudine
vertical transmission HIV drug resistance