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Intrapartum Tenofovir and Emtricitabine Reduces Low-Concentration Drug Resistance Selected by Single-Dose Nevirapine for Perinatal HIV Prevention
- Source :
- AIDS Research and Human Retroviruses. 25:1099-1106
- Publication Year :
- 2009
- Publisher :
- Mary Ann Liebert Inc, 2009.
-
Abstract
- A single dose of tenofovir/emtricitabine (TDF/FTC) during labor significantly reduces peripartum nevirapine-associated viral drug resistance when measured by consensus HIV sequencing. It is unknown whether this effect extends to HIV subpopulations of25-50%. We conducted a randomized trial of single-dose TDF/FTC added to peripartum nevirapine to reduce drug resistance associated with nonnucleoside reverse transcriptase inhibitors (NNRTIs). To detect mutations for NNRTIs comprisingor = 2% of the viral population, we used an oligonucleotide ligation assay (OLA) at codons 103, 106, 181, and 190 of HIV reverse transcriptase. To assess development of drug resistance mutations to our study intervention, OLA was also performed at codons 65 and 184. Among the 328 women included in the 2-week analysis, those receiving TDF/FTC were less likely to have NNRTI resistance by OLA (RR = 0.40, 95% CI = 0.21-0.77). A similar trend was observed among the 315 women included in the 6-week analysis (RR = 0.45, 95% CI = 0.31-0.66). Only two (1%) specimens had detectable K65R by OLA. Both were at 6 weeks postpartum; one was detected in the intervention arm and one in the control arm (p = 0.96). M184V was not detected. The ability of single-dose TDF/FTC to protect against peripartum NVP-induced NNRTI resistance extends to minority populations. This efficacy is achieved without significant selection of TDF- or FTC-resistant viruses.
- Subjects :
- Oncology
medicine.medical_specialty
Nevirapine
Anti-HIV Agents
Immunology
Population
Organophosphonates
HIV Infections
Drug resistance
Emtricitabine
Deoxycytidine
Drug Administration Schedule
Pharmacotherapy
Pregnancy
Virology
Internal medicine
Drug Resistance, Viral
medicine
Humans
Pregnancy Complications, Infectious
Clinical Trials/Clinical Studies
Tenofovir
education
education.field_of_study
Dose-Response Relationship, Drug
biology
business.industry
Adenine
virus diseases
Resistance mutation
biology.organism_classification
HIV Reverse Transcriptase
Infectious Disease Transmission, Vertical
Reverse transcriptase
Treatment Outcome
Infectious Diseases
Mutation
Lentivirus
HIV-1
Reverse Transcriptase Inhibitors
Drug Therapy, Combination
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 19318405 and 08892229
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- AIDS Research and Human Retroviruses
- Accession number :
- edsair.doi.dedup.....5a275505adc67caa26feb7540b69c8ee