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Low rate of DRMs, vertical transmission of HIV-1 among women treated with Option B+

14 Jul 2017
The 2012 WHO guidelines recommend the initiation of lifelong antiretroviral combination therapy for all pregnant HIV-1 positive women in resource-limited settings regardless of their CD4 count or clinical stage to prevent mother-to-child transmission of HIV-1 (Option B+). There has been some concern that such programmes may encourage the development of drug resistance mutations (DRMs), but a recent study has shown that the risk of drug resistance is low.

A total of 124 HIV-1 positive pregnant women in Fort Portal, Uganda, were enrolled in the study. Blood samples were collected at their first visit to the antenatal clinic before initiating Option B+ as well as at 6 weeks and 6, 12, and 18 months postpartum. Viral load was determined by real-time RT-PCR and analyses were also made of vertical transmission. A total of 49 women (39.5 percent) were also included in a DRM analysis. Virological failure was defined as >1,000 copies HIV-1 RNA/mL.

At 1-year postpartum, three women were found to have virological failure, and seven were affected by the 18-month time point. No vertical transmission of HIV-1 was noted among the 49 mother-infant pairs included in the DRM analysis. However, three women had developed DRMs, and two had dual-class resistance against all recommended first-line drugs.

The researchers suggested that their findings of a low DRM selection rate support the continued adoption of the Option B+ for preventing mother-to-child transmission of HIV-1.
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Most Read Articles
6 days ago
In pregnant women, adherence to recommended dietary intake of fat and fibre is associated with a more beneficial and richer gut microbiota which, in turn, decreases levels of the inflammation marker glycoprotein acetylation (GlycA), a study has shown.
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Dr Joon Kiong Lee discusses pharmacotherapy for osteoporosis and the role of FLS in fracture prevention
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