dc.contributor.author | Lehman, DA | |
dc.contributor.author | Chung, MH | |
dc.contributor.author | Mabuka, JM | |
dc.contributor.author | John-Stewart, GC | |
dc.contributor.author | Kiarie, J | |
dc.contributor.author | Kinuthia, J | |
dc.contributor.author | Overbaugh, J | |
dc.date.accessioned | 2013-06-12T09:12:44Z | |
dc.date.available | 2013-06-12T09:12:44Z | |
dc.date.issued | 2009-08 | |
dc.identifier.citation | J Acquir Immune Defic Syndr. 2009 Aug 15;51(5):522-9. doi: 10.1097/QAI.0b013e3181aa8a22. | en |
dc.identifier.uri | http://www.ncbi.nlm.nih.gov/pubmed/19502990 | |
dc.identifier.uri | http://erepository.uonbi.ac.ke:8080/xmlui/handle/123456789/32101 | |
dc.description.abstract | Antiretroviral resistance after short-course regimens used to prevent mother-to-child transmission has consequences for later treatment. Directly comparing the prevalence of resistance after short-course regimens of highly active antiretroviral therapy (HAART) and zidovudine plus single-dose nevirapine (ZDV/sdNVP) will provide critical information when assessing the relative merits of these antiretroviral interventions.
METHODS:
In a clinical trial in Kenya, pregnant women were randomized to receive either ZDV/sdNVP or a short-course of HAART through 6 months of breastfeeding. Plasma samples were collected 3-12 months after treatment cessation, and resistance to reverse transcriptase inhibitors was assessed using both a sequencing assay and highly sensitive allele-specific polymerase chain reaction assays.
RESULTS:
No mutations associated with resistance were detectable by sequencing in either the ZDV/sdNVP or HAART arms at 3 months posttreatment, indicating that resistant viruses were not present in >20% of virus. Using allele-specific polymerase chain reaction assays for K103N and Y181C, we detected low levels of resistant virus in 75% of women treated with ZDV/sdNVP and only 18% of women treated with HAART (P = 0.007). Y181C was more prevalent than K103N at 3 months and showed little evidence of decay by 12 months.
CONCLUSIONS:
Our finding provides evidence that compared with ZDV/sdNVP, HAART reduces but does not eliminate nevirapine resistance. | en |
dc.language.iso | en | en |
dc.publisher | Univesity of Nairobi | en |
dc.title | Lower risk of resistance after short-course HAART compared with zidovudine/single-dose nevirapine used for prevention of HIV-1 mother-to-child transmission. | en |
dc.type | Article | en |
local.publisher | Department of Medicine | en |