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  • Title: Detection of HIV drug resistance mutations in pregnant women receiving single dose Nevirapine in south India.
    Author: Jacob MS, Durairaj A, Vijayakumari J, Srijayanth P, Sivakumar MR.
    Journal: Indian J Pathol Microbiol; 2011; 54(2):359-61. PubMed ID: 21623090.
    Abstract:
    BACKGROUND: Single dose of Nevirapine to prevent mother to child transmission of HIV is the commonest preventive regimen in resource-limited countries. OBJECTIVES: The objective of this study was to detect drug-resistant virus after single dose of Nevirapine (sdNVP) provided to delivering HIV seropositive (HIV+ve) women and to evaluate the time taken for its decay. RESULTS: Of the 36 consenting HIV+ve pregnant women enrolled into the study, the mean hemoglobin and total lymphocyte counts were 10.8 g/dl and 1843 cells/mm 3 , respectively. Mean CD4 counts in 64% of women was 363 cells/mm 3 and mean viral load for 16/36 women was 28,143 copies/ml of plasma. Nevirapine-resistance mutations were detected in 28% of women at delivery; using OLA (Oligonucleotide Ligation Assay). K103N mutations were seen in 19.4% of women while the Y181C mutation was seen in 5%. Both the mutations were detected in 2.7% of women. Sequential blood samples collected at delivery, 7-10 days, 6 weeks, 4 months, 6 months and one year postpartum showed that 81% of K103N mutations and 66.7% of Y181C mutations were detected at 6 weeks postpartum . Wild-type virus had replaced the mutants by one year postpartum in all women except one. CONCLUSION: These observations are relevant for future treatment with antiretroviral therapy in these women for their HIV disease.
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