| Title: |
Addition of 7 days of zidovudine plus lamivudine to peripartum single-dose nevirapine effectively reduces nevirapine resistance postpartum in HIV-infected mothers in Malawi. |
| Authors: |
Farr, SL; Nelson, JA; Ng'ombe, TJ; Kourtis, AP; Chasela, C; Johnson, JA; Kashuba, AD; Tegha, GL; Wiener, J; Eron, JJ; Banda, HN; Mpaso, M; Lipscomb, J; Matiki, C; Fiscus, SA; Jamieson, DJ; van der Horst, C; BAN Study Team.; Meme, J |
| Publisher Information: |
University of Nairobi |
| Publication Year: |
2010 |
| Collection: |
University of Nairobi Digital Repository |
| Description: |
BACKGROUND: We assessed whether 7 days of zidovudine + lamivudine postpartum with single-dose nevirapine at labor decreases nevirapine resistance in HIV-infected women in Malawi. METHODS: HIV-infected pregnant women receiving intrapartum single-dose nevirapine and 7 days of zidovudine + lamivudine (n = 132) and women receiving intrapartum single-dose nevirapine alone (n = 66) were followed from an antenatal visit through 6 weeks postpartum. Plasma specimens at 2 and 6 weeks postpartum were tested for genotypic resistance to nevirapine by population sequencing and sensitive real-time polymerase chain reaction. Poisson regression was used to determine predictors of postpartum nevirapine resistance. RESULTS: Median HIV RNA was similar at entry (4.27 log vs. 4.35 log, P = 0.87), differed at 2 weeks postpartum (2.67 log vs. 3.58 log, P < 0.0001) but not at 6 weeks postpartum (4.49 log vs. 4.40 log, P = 0.79), between single-dose nevirapine/zidovudine + lamivudine and single-dose nevirapine groups, respectively. Nevirapine resistance, measured by population sequencing and sensitive real-time polymerase chain reaction, was significantly less common in those receiving single-dose nevirapine/zidovudine + lamivudine compared with single-dose nevirapine, respectively, at 2 weeks [10% (4 of 40) vs. 74% (31 of 42), P < 0.0001] and 6 weeks postpartum [10% (11 of 115) vs. 64% (41 of 64), P < 0.0001; adjusted relative risk = 0.18, 95% confidence interval (0.10 to 0.34)]. CONCLUSIONS: The significant decrease in nevirapine resistance conferred by 1 week of zidovudine + lamivudine should help policymakers optimize peripartum HIV prophylaxis recommendations. |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
http://www.ncbi.nlm.nih.gov/pubmed/20672451; https://hdl.handle.net/11295/66192 |
| Availability: |
https://hdl.handle.net/11295/66192; http://www.ncbi.nlm.nih.gov/pubmed/20672451 |
| Accession Number: |
edsbas.F53C4015 |
| Database: |
BASE |