Back to Search
Start Over
Human Immunodeficiency Virus Antiretroviral Resistance and Transmission in Mother-Infant Pairs Enrolled in a Large Perinatal Study.
- Source :
-
Clinical Infectious Diseases . Jun2018, Vol. 66 Issue 11, p1770-1777. 8p. - Publication Year :
- 2018
-
Abstract
- Background. The presence of antiretroviral drug-associated resistance mutations (DRMs) may be particularly problematic in human immunodeficiency virus (HIV)-infected pregnant women as it can lead to mother-to-child transmission (MTCT) of resistant HIV strains. This study evaluated the prevalence and the effect of antiretroviral DRMs in previously untreated mother-infant pairs. Methods. A case-control design of 1:4 (1 transmitter to 4 nontransmitters) was utilized to evaluate DRMs as a predictor of HIV MTCT in specimens obtained from mother-infant pairs. ViroSeq HIV-1 genotyping was performed on mother-infant specimens to assess for clinically relevant DRMs. Results. One hundred forty infants acquired HIV infection; of these, 123 mother-infant pairs (88%) had specimens successfully amplified using ViroSeq and assessed for drug resistance genotyping. Additionally, 483 of 560 (86%) women who did not transmit HIV to infants also had samples evaluated for DRMs. Sixty-three of 606 (10%) women had clinically relevant DRMs; 12 (2%) had DRMs against >1 drug class. Among 123 HIV-infected infants, 13 (11%) had clinically relevant DRMs, with 3 (2%) harboring DRMs against >1 drug class. In univariate and multivariate analyses, DRMs in mothers were not associated with increased HIV MTCT (adjusted odds ratio, 0.8 [95% confidence interval, .4-1.5]). Presence of DRMs in transmitting mothers was strongly associated with DRM presence in their infants (P < .001). Conclusions. Preexisting DRMs were common in untreated HIV-infected pregnant women, but did not increase the risk of HIV MTCT. However, if women with DRMs are not virologically suppressed, they may transmit resistant mutations, thus complicating infant management. [ABSTRACT FROM AUTHOR]
- Subjects :
- *HIV infection genetics
*HIV infection transmission
*ANTIRETROVIRAL agents
*COLLECTION & preservation of biological specimens
*CONFIDENCE intervals
*DRUG resistance in microorganisms
*HIV infections
*MOTHERS
*MULTIVARIATE analysis
*GENETIC mutation
*STATISTICS
*DISEASE prevalence
*CASE-control method
*VERTICAL transmission (Communicable diseases)
*ODDS ratio
*GENOTYPES
Subjects
Details
- Language :
- English
- ISSN :
- 10584838
- Volume :
- 66
- Issue :
- 11
- Database :
- Academic Search Index
- Journal :
- Clinical Infectious Diseases
- Publication Type :
- Academic Journal
- Accession number :
- 129723089
- Full Text :
- https://doi.org/10.1093/cid/cix1104