Skip to main content
Journal cover image

Clonal amplification and maternal-infant transmission of nevirapine-resistant HIV-1 variants in breast milk following single-dose nevirapine prophylaxis.

Publication ,  Journal Article
Permar, SR; Salazar, MG; Gao, F; Cai, F; Learn, GH; Kalilani, L; Hahn, BH; Shaw, GM; Salazar-Gonzalez, JF
Published in: Retrovirology
August 14, 2013

BACKGROUND: Intrapartum administration of single-dose nevirapine (sdNVP) reduces perinatal HIV-1 transmission in resource-limiting settings by half. Yet this strategy has limited effect on subsequent breast milk transmission, making the case for new treatment approaches to extend maternal/infant antiretroviral prophylaxis through the period of lactation. Maternal and transmitted infant HIV-1 variants frequently develop NVP resistance mutations following sdNVP, complicating subsequent treatment/prophylaxis regimens. However, it is not clear whether NVP-resistant viruses are transmitted via breastfeeding or arise de novo in the infant. FINDINGS: We performed a detailed HIV genetic analysis using single genome sequencing to identify the origin of drug-resistant variants in an sdNVP-treated postnatally-transmitting mother-infant pair. Phylogenetic analysis of HIV sequences from the child revealed low-diversity variants indicating infection by a subtype C single transmitted/founder virus that shared full-length sequence identity with a clonally-amplified maternal breast milk virus variant harboring the K103N NVP resistance mutation. CONCLUSION: In this mother/child pair, clonal amplification of maternal NVP-resistant HIV variants present in systemic and mammary gland compartments following intrapartum sdNVP represents one source of transmitted NVP-resistant variants that is responsible for the acquisition of drug resistant virus by the breastfeeding infant. This finding emphasizes the need for combination antiretroviral prophylaxis to prevent mother-to-child HIV transmission.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Retrovirology

DOI

EISSN

1742-4690

Publication Date

August 14, 2013

Volume

10

Start / End Page

88

Location

England

Related Subject Headings

  • Virology
  • Sequence Homology
  • Sequence Analysis, DNA
  • RNA, Viral
  • Pregnancy
  • Phylogeny
  • Nevirapine
  • Molecular Sequence Data
  • Molecular Epidemiology
  • Milk, Human
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Permar, S. R., Salazar, M. G., Gao, F., Cai, F., Learn, G. H., Kalilani, L., … Salazar-Gonzalez, J. F. (2013). Clonal amplification and maternal-infant transmission of nevirapine-resistant HIV-1 variants in breast milk following single-dose nevirapine prophylaxis. Retrovirology, 10, 88. https://doi.org/10.1186/1742-4690-10-88
Permar, Sallie R., Maria G. Salazar, Feng Gao, Fangping Cai, Gerald H. Learn, Linda Kalilani, Beatrice H. Hahn, George M. Shaw, and Jesus F. Salazar-Gonzalez. “Clonal amplification and maternal-infant transmission of nevirapine-resistant HIV-1 variants in breast milk following single-dose nevirapine prophylaxis.Retrovirology 10 (August 14, 2013): 88. https://doi.org/10.1186/1742-4690-10-88.
Permar, Sallie R., et al. “Clonal amplification and maternal-infant transmission of nevirapine-resistant HIV-1 variants in breast milk following single-dose nevirapine prophylaxis.Retrovirology, vol. 10, Aug. 2013, p. 88. Pubmed, doi:10.1186/1742-4690-10-88.
Permar SR, Salazar MG, Gao F, Cai F, Learn GH, Kalilani L, Hahn BH, Shaw GM, Salazar-Gonzalez JF. Clonal amplification and maternal-infant transmission of nevirapine-resistant HIV-1 variants in breast milk following single-dose nevirapine prophylaxis. Retrovirology. 2013 Aug 14;10:88.
Journal cover image

Published In

Retrovirology

DOI

EISSN

1742-4690

Publication Date

August 14, 2013

Volume

10

Start / End Page

88

Location

England

Related Subject Headings

  • Virology
  • Sequence Homology
  • Sequence Analysis, DNA
  • RNA, Viral
  • Pregnancy
  • Phylogeny
  • Nevirapine
  • Molecular Sequence Data
  • Molecular Epidemiology
  • Milk, Human