Resistance Detected by Pyrosequencing Following Zidovudine Monotherapy for Prevention of HIV-1 Mother-To-Child-Transmission

AIDS. 2015 Jul 31;29(12):1467-71. doi: 10.1097/QAD.0000000000000737.

Abstract

To prevent mother-to-child-transmission of HIV-1, the 2010 WHO guidelines recommended prenatal zidovudine (ZDV) monotherapy (option A). To determine if ZDV monotherapy selects for HIV resistance in antiretroviral-naive women during pregnancy, specimens from 50 individuals were examined using pyrosequencing. ZDV-resistance mutations were detected at delivery in seven women (14%, 95% confidence interval 6.6-26.5%). These data raise the question whether women administered ZDV monotherapy for prevention of mother-to-child-transmission could have higher risk of virologic failure when later started on combination antiretroviral therapy, as has been demonstrated following single-dose nevirapine prophylaxis.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Amino Acid Substitution
  • Anti-HIV Agents / administration & dosage*
  • Chemoprevention / methods
  • Drug Resistance, Viral*
  • Female
  • Genotype
  • HIV Infections / drug therapy
  • HIV Infections / prevention & control
  • HIV Infections / transmission
  • HIV Infections / virology*
  • HIV Reverse Transcriptase / genetics
  • HIV-1 / drug effects*
  • HIV-1 / genetics
  • HIV-1 / isolation & purification
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Mutation, Missense
  • Pregnancy
  • Pregnancy Complications, Infectious / drug therapy
  • Pregnancy Complications, Infectious / virology*
  • RNA, Viral / genetics
  • Sequence Analysis, DNA
  • Young Adult
  • Zidovudine / administration & dosage*

Substances

  • Anti-HIV Agents
  • RNA, Viral
  • Zidovudine
  • reverse transcriptase, Human immunodeficiency virus 1
  • HIV Reverse Transcriptase