Abstract
To prevent mother-to-child-transmission of HIV-1, the 2010 WHO guidelines recommended prenatal zidovudine (ZDV) monotherapy (option A). To determine if ZDV monotherapy selects for HIV resistance in antiretroviral-naive women during pregnancy, specimens from 50 individuals were examined using pyrosequencing. ZDV-resistance mutations were detected at delivery in seven women (14%, 95% confidence interval 6.6-26.5%). These data raise the question whether women administered ZDV monotherapy for prevention of mother-to-child-transmission could have higher risk of virologic failure when later started on combination antiretroviral therapy, as has been demonstrated following single-dose nevirapine prophylaxis.
Publication types
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Clinical Trial
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Research Support, N.I.H., Extramural
MeSH terms
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Adult
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Amino Acid Substitution
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Anti-HIV Agents / administration & dosage*
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Chemoprevention / methods
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Drug Resistance, Viral*
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Female
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Genotype
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HIV Infections / drug therapy
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HIV Infections / prevention & control
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HIV Infections / transmission
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HIV Infections / virology*
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HIV Reverse Transcriptase / genetics
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HIV-1 / drug effects*
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HIV-1 / genetics
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HIV-1 / isolation & purification
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Humans
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Infant, Newborn
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Infectious Disease Transmission, Vertical / prevention & control*
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Mutation, Missense
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Pregnancy
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Pregnancy Complications, Infectious / drug therapy
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Pregnancy Complications, Infectious / virology*
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RNA, Viral / genetics
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Sequence Analysis, DNA
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Young Adult
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Zidovudine / administration & dosage*
Substances
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Anti-HIV Agents
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RNA, Viral
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Zidovudine
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reverse transcriptase, Human immunodeficiency virus 1
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HIV Reverse Transcriptase