AEGiS-15IAC: Nevirapine resistance mutations among HIV-1 infected infants following single dose nevirapine.

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

Nevirapine resistance mutations among HIV-1 infected infants following single dose nevirapine.

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. WeOrB1290)

Pillay CC, Gray G, Chezzi C, Ntsala M, Stevens G, Stevens W, Lupondwana P, Martinson N, Puren A, Moodley D, McIntyre J, Morris L
National Institute of Communicable Diseases, Johannesburg, South Africa

BACKGROUND: One of the potential obstacles to the success of nevirapine (NVP) to prevent mother-to-child transmission of HIV-1 is the emergence of drug resistant variants. This study assessed the rates of resistance among infants enrolled in the standard regimen (SR) where both mothers and infants receive NVP compared to those infants who received NVP as post exposure prophylaxis (PEP).

METHODS: Samples obtained from 47 HIV-1 infected infants) 6 weeks post NVP (24 on the SR and 23 on the PEP regimen were analyzed for the presence of drug resistance mutations using an in-house genotyping assay.

RESULTS: All infants were infected with HIV-1 subtype C viruses. Among the infants on the PEP regimen 3 of 23 (13%) had mutations conferring high level resistance to NVP; these were Y181C, Y181C plus K103N and Y181C plus V106M. A fourth infant had the K101E which is reported to confer low-level resistance to NVP. The Y181C mutation was found in 8 of 24 (33%) infants on the SR.

CONCLUSIONS: Exposure to NVP is associated with the development of resistance in infected infants. Preliminary data suggest that the PEP regimen is associated with a lower frequency of resistance compared to the standard regimen.

Keywords: AEGIS, Nevirapine, HIV-1, HIV-1 Reverse Transcriptase, Single Person, Mutation, Infant, Humans, Child, genetics

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