HIV-1 Drug Resistance by Ultra-Deep Sequencing Following Short Course Zidovudine, Single-Dose Nevirapine, and Single-Dose Tenofovir with Emtricitabine for Prevention of Mother-to-Child Transmission.

摘要: Antiretroviral drug resistance following pMTCT strategies remains a significant problem. With rapid advancements in next generation sequencing technologies, there is more focus on HIV drug-resistant variants of low frequency, or the so-called minority variants. In South Africa, AZT monotherapy for pMTCT, similar to World Health Organization option A, has been used since 2008. 2010, single dose co-formulated TDF/FTC was included strategy prevention conferred by single-dose nevirapine (sd NVP). The study conducted KwaZulu-Natal, among participants who received from 14 weeks gestation, intrapartum and sd NVP, postpartum TDF/FTC. Twenty-six specimens collected at 6 post-delivery were successfully sequenced using 454 ultra-deep sequencing. Non-nucleoside reverse transcriptase inhibitor (NNRTI) detected 17 26 (65%) patients, 2 (7%) had Thymidine analogue mutations, 3 (11%) K65R. Of patients with NNRTI resistance, 11 high-level whereas (35%) intermediate resistance. levels are much higher than would be expected, given inclusion antepartum This high level could impact future NNRTI-containing treatment large proportion pMTCT-exposed women. detection mutations highlights need understand clinical these AZT-containing antiretroviral women exposed monotherapy.