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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
09 Jan 2018
In pregnant mothers entering the third trimester, choline supplementation of approximately twice the recommended amount improves information processing in the offspring, a recent randomized, double-blind, controlled feeding study has shown.
01 Mar 2018
Acupuncture appears to be a safe and effective approach to reducing lumbopelvic pain during pregnancy, a recent New Zealand study has shown.
06 May 2018
Healthy young women with elevations in preconception blood pressure appear to be at increased risk of pregnancy loss, according to a study.
Pearl Toh, 03 Apr 2018
One third of women who have been in a relationship have experienced some form of physical and/or sexual violence by their intimate partner in their lifetime, and pregnant women are particularly vulnerable to domestic violence and abuse (DVA), said President of RCOG Professor Lesley Regan at the recent RCOG World Congress 2018 in Singapore.