Nevirapine Resistance and Breast-Milk HIV Transmission in Infants
Author Information
Author(s): Moorthy Anitha, Gupta Amita, Bhosale Ramesh, Tripathy Srikanth, Sastry Jayagowri, Kulkarni Smita, Thakar Madhuri, Bharadwaj Renu, Kagal Anju, Bhore Arvind V., Patil Sandesh, Kulkarni Vandana, Venkataramani Varadharajan, Balasubramaniam Usha, Suryavanshi Nishi, Ziemniak Carrie, Gupte Nikhil, Bollinger Robert, Persaud Deborah
Primary Institution: Johns Hopkins University
Hypothesis
Does extended-dose nevirapine prophylaxis increase the risk of nevirapine resistance in HIV-infected infants compared to single-dose nevirapine?
Conclusion
Extended-dose nevirapine prophylaxis increases the likelihood of nevirapine resistance in infants infected within the first six weeks of life.
Supporting Evidence
- Infants diagnosed with HIV in the first six weeks of life had a higher prevalence of nevirapine resistance when receiving extended-dose nevirapine.
- 92% of infants receiving extended-dose nevirapine had nevirapine resistance compared to 38% of those receiving single-dose nevirapine.
- Resistance mutations were similar between the two groups but differed by timing of infection.
Takeaway
Giving babies medicine to prevent HIV can sometimes make the virus stronger if they get infected early on.
Methodology
The study used standard population sequencing and cloning to analyze HIV genotypes from infected infants.
Potential Biases
Potential bias due to loss to follow-up and limited sample sizes for certain analyses.
Limitations
The study could not test for nevirapine resistance at a fixed time point and had a limited number of maternal samples for genotyping.
Participant Demographics
Infants enrolled were HIV-infected and received either single-dose or extended-dose nevirapine prophylaxis.
Statistical Information
P-Value
0.002
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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