Zidovudine with nevirapine for the prevention of HIV mother-to-child transmission reduces nevirapine resistance in mothers from the Western Cape, South Africa

Journal of Medical Virology
Gert U van ZylWolfgang Preiser

Abstract

In the Western Cape province of South Africa, an intensified regimen for the prevention-of-mother-to-child-transmission-of-HIV consisting of zidovudine (AZT) from 34 weeks of pregnancy plus single dose (sd) nevirapine (NVP) during labor was instituted in 2004. The newborn baby receives a single dose of NVP and AZT for 7 days. Similar strategies in Thailand and Africa have been shown to be more effective in reducing transmission than NVP alone. The use of sd NVP only for the prevention-of-mother-to-child-transmission-of-HIV has a high risk of inducing resistance (25-69%) with an average of 35.7% by a recent meta-analysis and has been shown to adversely affect non-nucleoside reverse transcriptase inhibitor (NNRTI)-based antiretroviral therapy when initiated within 6 months. In this study the prevalence of resistance to NVP and AZT in mothers who had received the intensified regimen was measured. Specimens collected from mothers were genotyped by in-house PCR and sequencing. In specimens obtained within 60 days of delivery, acquired NVP resistance mutations were detected in 13 of 76 patients (17.1%, 95% confidence interval: 8.7-25.6%), which appears to be lower than in studies with sd NVP alone (37.5%, 95% confidence interval: 23....Continue Reading

References

Jul 13, 2004·The New England Journal of Medicine·Marc LallemantUNKNOWN Perinatal HIV Prevention Trial (Thailand) Investigators
Jul 13, 2004·The New England Journal of Medicine·Gonzague JourdainUNKNOWN Perinatal HIV Prevention Trial Group
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Sep 14, 2007·American Journal of Obstetrics and Gynecology·Michelle S McConnellSusan H Eshleman

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Citations

May 23, 2002·Journal of Health Economics·Jolene Skordis, Nicoli Nattrass
Oct 15, 2010·The New England Journal of Medicine·Shahin LockmanUNKNOWN OCTANE A5208 Study Team
Nov 1, 2008·The Journal of Antimicrobial Chemotherapy·Andrea KunzGundel Harms
Sep 26, 2009·The Pediatric Infectious Disease Journal·Gert U van ZylWolfgang Preiser
Feb 27, 2009·Current Opinion in Pediatrics·Kenneth L Muldrew
Jan 18, 2011·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Gert Uves van ZylGary Maartens
Jan 6, 2012·Journal of Acquired Immune Deficiency Syndromes : JAIDS·Jim AizireMary Glenn Fowler
Nov 21, 2015·Tropical Medicine & International Health : TM & IH·Christopher J HoffmannGert U van Zyl
Jul 17, 2016·Infection, Genetics and Evolution : Journal of Molecular Epidemiology and Evolutionary Genetics in Infectious Diseases·Eduan WilkinsonTulio de Oliveira
Jan 27, 2010·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Raghda K Elsayed, David J Caldwell
Nov 9, 2016·The Cochrane Database of Systematic Reviews·Amanda J Mason-JonesCarl Lombard
Nov 17, 2011·Journal of the International AIDS Society·Gert U van ZylMark F Cotton
Jul 14, 2018·Frontiers in Chemistry·Chris N J Young, Dariusz C Górecki

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