Skip Navigation LinksHome > February 20, 2010 - Volume 24 - Issue 4 > Emergence and persistence of nevirapine resistance in breast...
doi: 10.1097/QAD.0b013e3283346e60
Clinical Science: Concise Communication

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

Hudelson, Sarah Ea; McConnell, Michelle Sb; Bagenda, Danstanc,d; Piwowar-Manning, Estellea; Parsons, Teresa Le; Nolan, Monica Lf; Bakaki, Paul Mg; Thigpen, Michael Cb; Mubiru, Michaeld; Fowler, Mary Glenna; Eshleman, Susan Ha

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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.

© 2010 Lippincott Williams & Wilkins, Inc.


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