BACKGROUND: Single-dose nevirapine (sdNVP) is widely used to prevent mother-to-child transmission (PMTCT) of HIV-1. This may result in NVP resistance in both mother and infant. The significance of low levels of NVP resistance mutations in infants treated with NVP-containing antiretroviral treatment (ART) is unknown. OBJECTIVES: To determine the presence of pre-treatment NVP resistance in HIV-infected infants with and without prior NVP exposure. STUDY DESIGN: 33 HIV-1-infected infants in a PMTCT trial received NVP-containing ART (26 infants with prior NVP exposure). Plasma and buffy coat samples obtained prior to ART initiation were evaluated for drug resistance by bulk sequencing and allele-specific PCR (ASPCR). RESULTS: ViroSeq identified NVP resistance in 3 of 33 infants; all failed first-line therapy. Pre-ART plasma NVP resistance by ASPCR was detected in 9 of 16 children experiencing virologic failure compared to 4 of 17 children without virologic failure (risk ratio 2.4, CI 0.94-7.8, p=0.08). Proviral resistance was not associated with virologic failure (risk ratio 1.2, CI 0.8-2.0, p=0.40). In the nevirapine-exposed infants, those who started ART before 7 months had higher risk of virologic failure (RR 2.3, CI 0.96-9.2, p=0.11). CONCLUSIONS: Low level drug resistance detected in plasma after NVP exposure prior to ART initiation may be associated with virologic failure on ART, while resistance in the DNA reservoir was not predictive of treatment outcome. Copyright (c) 2010 Elsevier B.V. All rights reserved.
BACKGROUND: Single-dose nevirapine (sdNVP) is widely used to prevent mother-to-child transmission (PMTCT) of HIV-1. This may result in NVP resistance in both mother and infant. The significance of low levels of NVP resistance mutations in infants treated with NVP-containing antiretroviral treatment (ART) is unknown. OBJECTIVES: To determine the presence of pre-treatment NVP resistance in HIV-infectedinfants with and without prior NVP exposure. STUDY DESIGN: 33 HIV-1-infectedinfants in a PMTCT trial received NVP-containing ART (26 infants with prior NVP exposure). Plasma and buffy coat samples obtained prior to ART initiation were evaluated for drug resistance by bulk sequencing and allele-specific PCR (ASPCR). RESULTS: ViroSeq identified NVP resistance in 3 of 33 infants; all failed first-line therapy. Pre-ART plasma NVP resistance by ASPCR was detected in 9 of 16 children experiencing virologic failure compared to 4 of 17 children without virologic failure (risk ratio 2.4, CI 0.94-7.8, p=0.08). Proviral resistance was not associated with virologic failure (risk ratio 1.2, CI 0.8-2.0, p=0.40). In the nevirapine-exposed infants, those who started ART before 7 months had higher risk of virologic failure (RR 2.3, CI 0.96-9.2, p=0.11). CONCLUSIONS: Low level drug resistance detected in plasma after NVP exposure prior to ART initiation may be associated with virologic failure on ART, while resistance in the DNA reservoir was not predictive of treatment outcome. Copyright (c) 2010 Elsevier B.V. All rights reserved.
Authors: Roger L Shapiro; Ibou Thior; Peter B Gilbert; Shahin Lockman; Carolyn Wester; Laura M Smeaton; Lisa Stevens; S Jody Heymann; Thumbi Ndung'u; Simani Gaseitsiwe; Vladimir Novitsky; Joseph Makhema; Stephen Lagakos; Max Essex Journal: AIDS Date: 2006-06-12 Impact factor: 4.177
Authors: S Palmer; V Boltz; N Martinson; F Maldarelli; G Gray; J McIntyre; J Mellors; L Morris; J Coffin Journal: Proc Natl Acad Sci U S A Date: 2006-04-25 Impact factor: 11.205
Authors: Susan H Eshleman; Donald R Hoover; Shu Chen; Sarah E Hudelson; Laura A Guay; Anthony Mwatha; Susan A Fiscus; Francis Mmiro; Philippa Musoke; J Brooks Jackson; Newton Kumwenda; Taha Taha Journal: AIDS Date: 2005-12-02 Impact factor: 4.177
Authors: Ibou Thior; Shahin Lockman; Laura M Smeaton; Roger L Shapiro; Carolyn Wester; S Jody Heymann; Peter B Gilbert; Lisa Stevens; Trevor Peter; Soyeon Kim; Erik van Widenfelt; Claire Moffat; Patrick Ndase; Peter Arimi; Poloko Kebaabetswe; Patson Mazonde; Joseph Makhema; Kenneth McIntosh; Vladimir Novitsky; Tun-Hou Lee; Richard Marlink; Stephen Lagakos; Max Essex Journal: JAMA Date: 2006-08-16 Impact factor: 56.272
Authors: Tamara Flys; Dwight V Nissley; Cassidy W Claasen; Dana Jones; Chanjuan Shi; Laura A Guay; Philippa Musoke; Francis Mmiro; Jeffrey N Strathern; J Brooks Jackson; James R Eshleman; Susan H Eshleman Journal: J Infect Dis Date: 2005-06-01 Impact factor: 5.226
Authors: S H Eshleman; M Mracna; L A Guay; M Deseyve; S Cunningham; M Mirochnick; P Musoke; T Fleming; M Glenn Fowler; L M Mofenson; F Mmiro; J B Jackson Journal: AIDS Date: 2001-10-19 Impact factor: 4.177
Authors: Vlad Novitsky; Melissa Zahralban-Steele; Mary Fran McLane; Sikhulile Moyo; Erik van Widenfelt; Simani Gaseitsiwe; Joseph Makhema; M Essex Journal: J Clin Microbiol Date: 2015-06-03 Impact factor: 5.948
Authors: Ross S Milne; Rachel A Silverman; Ingrid A Beck; Jennifer Mckernan-Mullin; Wenjie Deng; Thomas R Sibley; Sandra Dross; James N Kiarie; Samah R Sakr; Robert W Coombs; Michael H Chung; Lisa M Frenkel Journal: AIDS Date: 2019-05-01 Impact factor: 4.177
Authors: Dara A Lehman; Dalton C Wamalwa; Connor O McCoy; Frederick A Matsen; Agnes Langat; Bhavna H Chohan; Sarah Benki-Nugent; Rebecca Custers-Allen; Frederic D Bushman; Grace C John-Stewart; Julie Overbaugh Journal: J Acquir Immune Defic Syndr Date: 2012-07-01 Impact factor: 3.731
Authors: Sera L Young; Mduduzi N N Mbuya; Caroline J Chantry; Eveline P Geubbels; Kiersten Israel-Ballard; Deborah Cohan; Stephen A Vosti; Michael C Latham Journal: Adv Nutr Date: 2011-04-30 Impact factor: 8.701