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No Clinically Significant Drug-Resistance Mutations in HIV-1 Subtype C–Infected Women After Discontinuation of NRTI-Based or PI-Based HAART for PMTCT in Botswana

Souda, Sajini MBBS, MD, DTM&H*,†; Gaseitsiwe, Simani PhD*; Georgette, Nathan; Powis, Kathleen MD, MPH*,§,‖; Moremedi, Daisy B.Bus*; Iketleng, Thato BSc*; Leidner, Jean MS; Moffat, Claire MBChB, MPH*; Ogwu, Anthony MBBS, MPH*; Lockman, Shahin MD, MSc*,‖,¶; Moyo, Sikhulile MPH*; Mmalane, Mompati FRCSEd, MSc*; Musonda, Rosemary PhD*; Makhema, Joseph MBChB, MRCP*; Essex, Max DVM, PhD*,‖; Shapiro, Roger MD, MPH*,‖,#

JAIDS Journal of Acquired Immune Deficiency Syndromes: August 15th, 2013 - Volume 63 - Issue 5 - p 572–577
doi: 10.1097/QAI.0b013e31829308f8
Brief Report: Basic and Translational Science

Abstract: Risk of developing drug resistance after stopping antiretroviral regimens to prevent mother-to-child HIV-1 transmission is unknown. The Mma Bana Study randomized treatment-naive pregnant women with CD4 ≥200 cells per cubic millimeter to receive either abacavir/zidovudine/lamivudine [triple nucleoside reverse transcriptase inhibitor (NRTI) arm] or lopinavir/ritonavir/zidovudine/lamivudine [protease inhibitor (PI) arm]. Drugs were discontinued after 6 months of breastfeeding. One month after discontinuation, 29 NRTI arm samples and 25 PI arm samples were successfully genotyped. No clinically significant antiretroviral resistance mutations were detected. Eight minor resistance mutations were found among 11 (20%) women (3 from NRTI arm and 8 from PI arm), occurring at similar frequencies to those reported in HIV-1 subtype C treatment-naive cohorts.

*Botswana–Harvard AIDS Institute Partnership for HIV Research and Education, Gaborone, Botswana;

Department of Pathology, School of Medicine, University of Botswana, Gaborone, Botswana;

Harvard University, Cambridge, MA;

§Department of Medicine and Pediatrics, Massachusetts General Hospital, Boston, MA;

Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA;

Department of Medicine, Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA; and

#Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA.

Correspondence to: Dr Sajini Souda, MBBS, MD, DTM&H, Private Bag UB 00712, Department of Pathology, School of Medicine Faculty of Health Sciences, University of Botswana, Gaborone, Botswana (e-mail:

Supported by the National Institute of Allergy and Infectious Diseases (U01AI066454) and National Institutes of Health.

Presented, in part, at the 19th Conference on Retroviruses and Opportunistic Infections, March 5–8, 2012, Seattle, WA.

No authors have a commercial or other association that might pose a conflict of interest (eg, pharmaceutical stock ownership, consultancy, advisory board membership, relevant patents, or research funding).

GenBank accession numbers: KC204763–KC204810 and KC852928-KC852933.

Received October 15, 2012

Accepted March 19, 2013

© 2013 by Lippincott Williams & Wilkins