Emergence of drug-resistant HIV-1 after intrapartum administration of single-dose nevirapine is substantially underestimated

Jeffrey A. Johnson, Jin Fen Li, Lynn Morris, Neil Martinson, Glenda Gray, James McIntyre, Walid Heneine

Research output: Contribution to journalArticle

Abstract

Conventional sequence analysis detects human immunodeficiency virus (HIV)-1 drug resistance mutations in ∼40% of women shortly after they receive intrapartum single-dose nevirapine (SD-NVP). Using sensitive real-time polymerase chain reaction assays for the K103N and Y181C resistance mutations, we tested genotyped virus before and after SD-NVP in 50 South African women infected with HIV-1 subtype C. By sequence analysis, 40 women had no detectable resistance mutations, and an additional 6 women were negative for Y181C after SD-NVP. We found K103N in 16 (40%) of 40 women and Y181C in 5 (11%) of 46 women at 6-36 weeks postpartum. Clonal sequencing confirmed K103N in 5 of 5 representative samples and Y181C in 4 of 4 samples. Four of the 5 women with newly identified Y181C also had K103N. These findings indicate that resistance mutations emerged in at least 65% of the women after SD-NVP and emphasize the importance of further research to determine the clinical implications.

Original languageEnglish (US)
Pages (from-to)16-23
Number of pages8
JournalJournal of Infectious Diseases
Volume192
Issue number1
DOIs
StatePublished - Jul 1 2005

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Nevirapine
HIV-1
Pharmaceutical Preparations
Mutation
Sequence Analysis
Drug Resistance
Postpartum Period
Real-Time Polymerase Chain Reaction
Viruses

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Immunology

Cite this

Emergence of drug-resistant HIV-1 after intrapartum administration of single-dose nevirapine is substantially underestimated. / Johnson, Jeffrey A.; Li, Jin Fen; Morris, Lynn; Martinson, Neil; Gray, Glenda; McIntyre, James; Heneine, Walid.

In: Journal of Infectious Diseases, Vol. 192, No. 1, 01.07.2005, p. 16-23.

Research output: Contribution to journalArticle

Johnson, Jeffrey A. ; Li, Jin Fen ; Morris, Lynn ; Martinson, Neil ; Gray, Glenda ; McIntyre, James ; Heneine, Walid. / Emergence of drug-resistant HIV-1 after intrapartum administration of single-dose nevirapine is substantially underestimated. In: Journal of Infectious Diseases. 2005 ; Vol. 192, No. 1. pp. 16-23.
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