AIDSWEEKLY Plus; Monday, December 10, 2001
Michael Greer, Senior Medical Writer

NewsRx -- Researchers in the United States say that HIV drug resistance mutations do not yet have a significant impact on the chance of maternal transmission.

Dr. Paul Palumbo and colleagues at the University of Medicine and Dentistry of New Jersey - New Jersey Medical School in Newark, the U.S. Centers for Disease Control and Prevention and Emory University in Atlanta, Georgia, Harlem Hospital and Columbia University in New York City, and the University of Maryland School of Medicine in Baltimore evaluated the "impact of antiretroviral resistance on perinatal transmission prevention efforts."

Although they found no link between viral resistance mutations and the effectiveness of transmission prevention, Palumbo and associates warned that this situation could change rapidly.

The researchers examined 220 infected women, all of whom had undergone zidovudine (AZT) therapy, and 24 of their newborn HIV⁺ children. The prevalence of viral mutations conferring AZT resistance was 17.3% in this population, they noted.

AZT resistance mutations were also found in 8.3% (2 of 23) of the infants studied, according to the report. However, the mutations seen in these children did not appear to be related to the maternal polymorphisms.

Despite the high prevalence of AZT-related mutations, viral resistance to protease inhibitors and nonnucleoside reverse transcriptase inhibitors was rarely observed (Antiretroviral resistance mutations among pregnant human immunodeficiency virus type 1-infected women and their newborns in the United States: Vertical transmission and clades, J Infect Dis 2001 Nov 1;184(9):1120-6.

"Although no effect of viral resistance on mother-infant transmission was demonstrated, the advent of more-potent drug classes and the potential for the rapid emergence of resistance warrant prospective surveillance," Palumbo and coauthors concluded.

The corresponding author for this report is Dr. Paul Palumbo, MSB-F-578, Dept. of Pediatrics, University of Medicine and Dentistry of New Jersey, 185 S. Orange Avenue, Newark, NJ 07103, USA. E-mail: palumbo@umdnj.edu.

Key points reported in this study include

• Viral drug resistance mutations do not seem to reduce the efficacy of AZT treatment to prevent vertical HIV transmission
  


• While almost 10% of infected newborns had viral populations resistant to zidovudine, the mutation patterns did not match their mothers'
  


• However, the emerging use of more powerful drugs to try and prevent vertical transmission may increase the relevance of resistance mutations
  

This article was prepared by AIDS Weekly editors from staff and other reports.

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