Nevirapine (NVP) resistance in women with HIV-1 subtype C, compared with subtypes A and D, after the administration of single-dose NVP

Susan H. Eshleman, Donald R. Hoover, Shu Chen, Sarah E. Hudelson, Laura A. Guay, Anthony Mwatha, Susan A. Fiscus, Francis Mmiro, Philippe Musoke, J. Brooks Jackson, Newton Kumwenda, Taha Taha

Research output: Contribution to journalArticlepeer-review

129 Scopus citations

Abstract

Objective. In the Human Immunodeficiency Virus (HIV) Network for Prevention Trials (HIVNET) 012 trial in Uganda, 6-8 weeks after single-dose nevirapine (SD-NVP), NVP resistance mutations were detected at a higher rate in women with HIV-1 subtype D than in women with subtype A. Here, we evaluate the rate of NVP resistance mutations in women with subtype C. Methods. NVP resistance mutations were detected using the ViroSeq HIV-1 Genotyping System. Results. The portion of women with any NVP resistance mutation was higher in those with subtype C (45/65 [69.2%] in the NVP and zidovudine trial, Malawi) than in those in the HIVNET 012 trial with either subtype A (28/144 [19.4%]; P < .0001) or subtype D (35/97 [36.1%]; P < .0001). In a multivariate model, subtype (C vs. A: odds ratio [OR], 8.73 [95% confidence interval {CI}, 4.29-17.76]; C vs. D: OR, 3.38 [95% CI, 1.65-6.93]) and viral load at delivery (OR, 2.35 [95% CI, 1.62-3.40]) independently predicted NVP resistance mutations, but maternal age, parity, and time between SD-NVP and the 6-8-week visit did not. Conclusions. The rate of NVP resistance mutations after SD-NVP was significantly higher in women with HIV-1 subtype C than in women with subtype A or D. Studies are needed to assess the clinical significance of this finding.

Original languageEnglish (US)
Pages (from-to)30-36
Number of pages7
JournalJournal of Infectious Diseases
Volume192
Issue number1
DOIs
StatePublished - Jul 1 2005

Bibliographical note

Funding Information:
Financial support: HIV Network for Prevention Trials, sponsored by the US National Institute of Allergy and Infectious Diseases (NIAID), the National Institutes of Health (NIH), and the Department of Health and Human Services (DHHS) through contracts with Family Health International (N01-AI-35173), Fred Hutchinson Cancer Research Center (N01-AI-45200), and Makerere University (NOI-AI-35173-417); HIV Prevention Trials Network, sponsored by the NIAID, the National Institutes of Child Health and Human Development, the National Institute on Drug Abuse, the National Institute of Mental Health, and the Office of AIDS Research of the NIH, DHHS (grants U01-AI-46745 and U01-AI-48054); Adult AIDS Clinical Trials Groups, sponsored by the NIH, Division of AIDS, NIAID (grant U01-AI-38858); NIH (grant R01-HD042965-01 to S.H.E.); Fogarty International Center, NIH (AIDS Fogarty International Research Collaborative Award and Supplement 5R03TW01199).

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