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

Sarah E. Hudelson, Michelle S. McConnell, Danstan S 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 Citations (Scopus)

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

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Nevirapine
Human Milk
HIV
Viral Load
HIV-1
CD4 Lymphocyte Count
Liquid Chromatography
Mass Spectrometry
Sodium
Genotype
Mothers

Keywords

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

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Infectious Diseases

Cite this

Hudelson, S. E., McConnell, M. S., Bagenda, D. S., Piwowar-Manning, E., Parsons, T. L., Nolan, M. L., ... 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

Emergence and persistence of nevirapine resistance in breast milk after single-dose nevirapine administration. / Hudelson, Sarah E.; McConnell, Michelle S.; Bagenda, Danstan S; Piwowar-Manning, Estelle; Parsons, Teresa L.; Nolan, Monica L.; Bakaki, Paul M.; Thigpen, Michael C.; Mubiru, Michael; Fowler, Mary Glenn; Eshleman, Susan H.

In: AIDS, Vol. 24, No. 4, 01.02.2010, p. 557-561.

Research output: Contribution to journalArticle

Hudelson, SE, McConnell, MS, Bagenda, DS, Piwowar-Manning, E, Parsons, TL, Nolan, ML, Bakaki, PM, Thigpen, MC, Mubiru, M, Fowler, MG & Eshleman, SH 2010, 'Emergence and persistence of nevirapine resistance in breast milk after single-dose nevirapine administration', AIDS, vol. 24, no. 4, pp. 557-561. https://doi.org/10.1097/QAD.0b013e3283346e60
Hudelson SE, McConnell MS, Bagenda DS, Piwowar-Manning E, Parsons TL, Nolan ML et al. Emergence and persistence of nevirapine resistance in breast milk after single-dose nevirapine administration. AIDS. 2010 Feb 1;24(4):557-561. https://doi.org/10.1097/QAD.0b013e3283346e60
Hudelson, Sarah E. ; McConnell, Michelle S. ; Bagenda, Danstan S ; Piwowar-Manning, Estelle ; Parsons, Teresa L. ; Nolan, Monica L. ; Bakaki, Paul M. ; Thigpen, Michael C. ; Mubiru, Michael ; Fowler, Mary Glenn ; Eshleman, Susan H. / Emergence and persistence of nevirapine resistance in breast milk after single-dose nevirapine administration. In: AIDS. 2010 ; Vol. 24, No. 4. pp. 557-561.
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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.",
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