AIDS

Skip Navigation LinksHome > February 20, 2010 - Volume 24 - Issue 4 > Emergence and persistence of nevirapine resistance in breast...
AIDS:
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

Collapse Box

Abstract

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.

Login

Article Tools

Share

Article Level Metrics

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.