Browsing by Author "Flysa, Tamara S."

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    Detection of K103N in Ugandan women after repeated exposure to single dose Nevirapine
    (Journal of virology, 2007) Flysa, Tamara S.; Mwathab, Anthony; Guay, Laura A.; Nakabiitoc, Clemensia; Donnell, Deborah; Musoke, Philippa; Mmirod, Francis; Jacksona, J. Brooks; Eshleman, Susan H.
    Objectives: Use of single dose nevirapine (SD NVP) for prevention of HIV-1 mother-tochild transmission (pMTCT) is associated with selection of K103N-containing HIV variants. Repeat use of SD NVP for pMTCT may influence emergence and persistence of NVP-resistant variants. Design: K103N-containing variants were studied in 48 Ugandan women who received SD NVP in the HIVNET 012 trial, and were re-exposed to SD NVP in one (n¼44) or two (n¼4) subsequent pregnancies during a 5-year follow-up study. Methods: Samples were analyzed using the LigAmp assay (assay cutoff: 0.5% K103N). Results: Among 44 women who were re-exposed to SD NVP in one subsequent pregnancy, 37.8% had K103N detected within 1 year of SD-NVP re-exposure. Detection of K103N was independently associated with detection of K103N 6–8 weeks after the first SD NVP exposure and with pre-NVP viral load. The portion of women with undetectable K103N by 2 years after SD NVP administration was similar after first versus second use of SD NVP for pMTCT. K103N was undetectable in 93.2% of evaluable women by 3 years of re-exposure. Only two of four women who received SD NVP in two pregnancies during the follow-up study had K103N detected after the last SD NVP exposure. Conclusions: K103N was detected in some women within 1 year of SD NVP reexposure, but faded from detection in most women by 3 years after re-exposure. Detection of K103N by 1 year after SD NVP re-exposure was associated with prior selection of K103N-containing variants and with pre-NVP viral load.