HIV-1 drug resistance by ultra-deep sequencing following short course zidovudine, single-dose nevirapine, and single-dose tenofovir with emtricitabine for prevention of mother-to-child transmission
Samuel, Reshmi (University of KwaZulu-Natal. Department of Virology)
Noguera-Julian, Marc (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Paredes, Roger (Institut Germans Trias i Pujol. Institut de Recerca de la Sida IrsiCaixa)
Parboosing, Raveen (University of KwaZulu-Natal. Department of Virology)
Moodley, Pravi (University of KwaZulu-Natal. Department of Virology)
Singh, Lavanya (University of KwaZulu-Natal. Department of Virology)
Naidoo, Anneta (University of KwaZulu-Natal. Department of Virology)
Gordon, Michelle (University of KwaZulu-Natal. Department of Virology)
Universitat Autònoma de Barcelona

Data:	2016
Resum:	Antiretroviral drug resistance following pMTCT strategies remains a significant problem. With rapid advancements in next generation sequencing technologies, there is more focus on HIV drug-resistant variants of low frequency, or the so-called minority variants. In South Africa, AZT monotherapy for pMTCT, similar to World Health Organization option A, has been used since 2008. In 2010, a single dose of co-formulated TDF/FTC was included in the strategy for prevention of resistance conferred by single-dose nevirapine (sd NVP). The study was conducted in KwaZulu-Natal, South Africa, among pMTCT participants who received AZT monotherapy from 14 weeks of gestation, intrapartum AZT and sd NVP, and postpartum sd TDF/FTC. Twenty-six specimens collected at 6 weeks post-delivery were successfully sequenced using 454 ultra-deep sequencing. Non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance was detected in 17 of 26 (65%) patients, 2 (7%) had Thymidine analogue mutations, and 3 (11%) had K65R. Of the 17 patients with NNRTI resistance, 11 (65%) had high-level NNRTI resistance, whereas 6 (35%) had intermediate NNRTI resistance. The levels of NNRTI resistance are much higher than would be expected, given the inclusion of antepartum AZT and postpartum TDF/FTC. This high level of NNRTI resistance could impact future NNRTI-containing treatment for a large proportion of pMTCT-exposed women. The detection of Thymidine analogue mutations highlights the need to understand the clinical impact of these on AZT-containing antiretroviral treatment in women exposed to AZT monotherapy.
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	HIV vertical transmission ; PMTCT ; HIV drug resistance
Publicat a:	Journal of acquired immune deficiency syndromes (1999), Vol. 73, issue 4 (Dec. 2016) , p. 384-389, ISSN 1944-7884

DOI: 10.1097/QAI.0000000000001116
PMID: 27327263

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