Important note: Information in this article was accurate in August 2002. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; August 19, 2002
Michael Greer, Senior Medical Writer
Coleen K. Cunningham and colleagues in the United States and France investigated the incidence of HIV drug resistance mutations in mothers and children treated with the non-nucleoside reverse transcriptase inhibitor.
Protective nevirapine therapy was associated with a significant increase in the appearance of resistance-conferring reverse transcriptase mutations, the researchers found.
Cunningham and coauthors reviewed data from Pediatric AIDS Clinical Trials Group protocol 316, an international trial conducted to assess nevirapine's ability to stave off mother-to-child HIV transmission. Participating mothers were treated with a single 200 mg dose of nevirapine during standard antiretroviral therapy, with their infant children receiving single 2 mg/kg nevirapine doses, according to the report.
The proportion of women with nevirapine-resistant viral populations rose from 2.3% before treatment to 15% after 6 weeks, study data showed. Neither viral load nor CD4 cell count had a significant impact on the development of resistance mutations.
The most frequently seen resistance mutation was K103N, which confers cross-resistance to efavirenz and other non-nucleoside reverse transcriptase inhibitors (Development of resistance mutations in women receiving standard antiretroviral therapy who received intrapartum nevirapine to prevent perinatal human immunodeficiency virus type 1 transmission: A substudy of Pediatric AIDS Clinical Trials Group protocol 316. J Infect Dis 2002 Jul 15;186(2):181-8).
"The risk of nevirapine resistance should be considered when determining the risks or benefits of intrapartum nevirapine in women receiving antepartum antiretroviral therapy," Cunningham and colleagues concluded.
The corresponding author for this report is Coleen K. Cunningham, State University of New York Upstate Medical University, Dept. of Pediatrics, 750 E. Adams St., Syracuse, NY 13210, USA. E-mail: cunningc@mail.upstate.edu.
Key points reported in this study include:
This article was prepared by AIDS Weekly editors from staff and other reports.
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