HPTN Bibliographic Record

Lee EJ, Kantor R, Zijenah L, Sheldon W, Emel L, Mateta P, Johnston E, Wells J, Shetty AK, Coovadia H, Maldonado Y, Adeniyi Jones S, Mofenson L, Contag CH, Bassett M, Katzenstein DA. Breast-milk shedding of drug-resistant HIV-1 Subtype C in women exposed to single-dose nevirapine. J Infect Dis. 2005, 192: 1260-4.
Single-dose nevirapine reduces intrapartum human immunodeficiency virus 1 type (HIV-1) transmission but may also select for nonnucleoside reverse-transcriptase inhibitor (NNRTI) resistance in breast milk (BM) and plasma. Among 32 Zimbabwean women, median 8-week postpartum plasma and BM HIV-1 RNA levels were 4.57 and 2.13 log10 copies/mL, respectively. BM samples from women with laboratory-diagnosed mastitis (defined as elevated BM Na+ levels) were 5.4-fold more likely to have HIV-1 RNA levels above the median. BM RT sequences were not obtained for 12 women with BM HIV-1 RNA levels below the lower limit of detection of the assay used. In 20 paired BM and plasma samples, 65% of BM and 50% of plasma RT sequences had NNRTI-resistance mutations, with divergent mutation patterns.