Emergence of NNRTI Drug Resistance in Infants in India

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Emergence of NNRTI Drug Resistance Mutations after Single-Dose

Nevirapine Exposure in HIV Type 1 Subtype C-Infected Infants in India

AIDS Research and Human Retroviruses

May 2007, Vol. 23, No. 5 : 682 -685

A feasibility study for providing single-dose nevirapine (SD-NVP)

prophylaxis for prevention of mother-to-child transmission (PMTCT) of

HIV infection provided an opportunity to study the emergence of

nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance

mutations as a result of single-dose administration. The study aimed

at the detection of NNRTI drug resistance mutations arising as a

result of SD-NVP. A total of 19 and 13 samples collected at 48 h and

2 months postpartum, respectively, from infants that were given SD-

NVP were studied for the presence of NNRTI drug resistance mutations

by PCR amplification and sequencing of the HIV-1 pol gene using HIV

proviral DNA. The drug resistance mutational analysis of final

sequences was carried out using the Stanford University HIV Drug

Resistance database (http://hivdb.stanford.edu/hiv). Mutations

associated with NNRTI drug resistance were observed in two (10.5%)

and six (46.15%) samples at 48 h and at 2 months, respectively.

K103N, one of the most common mutations, was not observed in any of

the samples. The emergence of NVP resistance must be weighed against

the simplicity, efficacy, and cost effectiveness of SD-NVP

prophylaxis in PMTCT settings in developing countries

Swarali N. Kurle, Department of Molecular Virology, National AIDS

Research Institute, Pune, India.

Raman R. Gangakhedkar, Department of Molecular Virology, National

AIDS Research Institute, Pune, India.

Sourav Sen, Command Hospitals, Pune, India.

Shilpa S. Hayatnagarkar, Department of Molecular Virology, National

AIDS Research Institute, Pune, India.

Srikanth P. Tripathy, Department of Molecular Virology, National AIDS

Research Institute, Pune, India.

Ramesh S. Paranjape, Department of Molecular Virology, National AIDS

Research Institute, Pune, India.