Emergence and persistence of nevirapine resistance in breast milk after single-dose nevirapine administration

Sarah E. Hudelson, Michelle S. McConnell, Danstan Bagenda, Estelle Piwowar-Manning, Teresa L. Parsons, Monica L. Nolan, Paul M. Bakaki, Michael C. Thigpen, Michael Mubiru, Mary Glenn Fowler, Susan H. Eshleman

Research output: Contribution to journalArticlepeer-review


Objective: Single-dose nevirapine (NVP) (sdNVP) can reduce the risk of HIV vertical transmission. We assessed risk factors for NVP resistance in plasma and breast milk from sdNVP-exposed Ugandan women. Methods: Samples were analyzed using the Roche AMPLICOR HIV-1 Monitor Test Kit, version 1.5, and the ViroSeq HIV-1 Genotyping System. NVP concentrations were determined by liquid chromatography with tandem mass spectroscopy. Results: HIV genotypes (plasma and breast milk) were obtained for 30 women 4 weeks after sdNVP (HIV subtypes: 15A, 1C, 12D, two recombinant). NVP resistance was detected in 12 (40%) of 30 breast milk samples. There was a nonsignificant trend between detection of NVP resistance in breast milk and plasma (P = 0.06). There was no association of HIV resistance in breast milk with median maternal pre-NVP viral load or CD4 cell count, median breast milk viral load at 4 weeks, breast milk sodium more than 10 mmol/l, HIV subtype, or concentration of NVP in breast milk or plasma. Conclusion: NVP resistance was frequently detected in breast milk 4 weeks after sdNVP exposure. In this study, we were unable to identify specific factors associated with breast milk NVP resistance.

Original languageEnglish (US)
Pages (from-to)557-561
Number of pages5
Issue number4
StatePublished - Feb 2010


  • Breast milk
  • HIV-1
  • Nevirapine
  • Nevirapine resistance
  • Uganda
  • Vertical transmission

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases


Dive into the research topics of 'Emergence and persistence of nevirapine resistance in breast milk after single-dose nevirapine administration'. Together they form a unique fingerprint.

Cite this