alexa Emergence of drug-resistant HIV-1 after intrapartum administration of single-dose nevirapine is substantially underestimated.
Microbiology

Microbiology

Journal of Antivirals & Antiretrovirals

Author(s): Johnson JA, Li JF, Morris L, Martinson N, Gray G,

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Abstract Conventional sequence analysis detects human immunodeficiency virus (HIV)-1 drug resistance mutations in approximately 40\% of women shortly after they receive intrapartum single-dose nevirapine (SD-NVP). Using sensitive real-time polymerase chain reaction assays for the K103N and Y181C resistance mutations, we tested genotyped virus before and after SD-NVP in 50 South African women infected with HIV-1 subtype C. By sequence analysis, 40 women had no detectable resistance mutations, and an additional 6 women were negative for Y181C after SD-NVP. We found K103N in 16 (40\%) of 40 women and Y181C in 5 (11\%) of 46 women at 6-36 weeks postpartum. Clonal sequencing confirmed K103N in 5 of 5 representative samples and Y181C in 4 of 4 samples. Four of the 5 women with newly identified Y181C also had K103N. These findings indicate that resistance mutations emerged in at least 65\% of the women after SD-NVP and emphasize the importance of further research to determine the clinical implications. This article was published in J Infect Dis and referenced in Journal of Antivirals & Antiretrovirals

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