Emergence and persistence of nevirapine resistance in breast milk after single-dose nevirapine administration

Sarah E. Hudelson, Michelle S. McConnell, Danstan Bagenda, Estelle Piwowar-Manning, Teresa L. Parsons, Monica L. Nolan, Paul M. Bakaki, Michael C. Thigpen, Michael Mubiru, Mary Glenn Fowler, Susan H. Eshleman

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Objective: Single-dose nevirapine (NVP) (sdNVP) can reduce the risk of HIV vertical transmission. We assessed risk factors for NVP resistance in plasma and breast milk from sdNVP-exposed Ugandan women. Methods: Samples were analyzed using the Roche AMPLICOR HIV-1 Monitor Test Kit, version 1.5, and the ViroSeq HIV-1 Genotyping System. NVP concentrations were determined by liquid chromatography with tandem mass spectroscopy. Results: HIV genotypes (plasma and breast milk) were obtained for 30 women 4 weeks after sdNVP (HIV subtypes: 15A, 1C, 12D, two recombinant). NVP resistance was detected in 12 (40%) of 30 breast milk samples. There was a nonsignificant trend between detection of NVP resistance in breast milk and plasma (P = 0.06). There was no association of HIV resistance in breast milk with median maternal pre-NVP viral load or CD4 cell count, median breast milk viral load at 4 weeks, breast milk sodium more than 10 mmol/l, HIV subtype, or concentration of NVP in breast milk or plasma. Conclusion: NVP resistance was frequently detected in breast milk 4 weeks after sdNVP exposure. In this study, we were unable to identify specific factors associated with breast milk NVP resistance.

Original languageEnglish (US)
Pages (from-to)557-561
Number of pages5
JournalAIDS
Volume24
Issue number4
DOIs
StatePublished - Feb 1 2010

Keywords

  • Breast milk
  • HIV-1
  • Nevirapine
  • Nevirapine resistance
  • Uganda
  • Vertical transmission

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

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  • Cite this

    Hudelson, S. E., McConnell, M. S., Bagenda, D., Piwowar-Manning, E., Parsons, T. L., Nolan, M. L., Bakaki, P. M., Thigpen, M. C., Mubiru, M., Fowler, M. G., & Eshleman, S. H. (2010). Emergence and persistence of nevirapine resistance in breast milk after single-dose nevirapine administration. AIDS, 24(4), 557-561. https://doi.org/10.1097/QAD.0b013e3283346e60