February 19, 2010
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Maternal exposure to nevirapine heightens chances of HIV-1 in breast-feeding infants

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Mothers who receive single-dose nevirapine may be at higher risk for passing on resistant HIV virus to their breast-feeding infant, according to data presented at the 17th Conference on Retroviruses and Opportunistic Infections in San Francisco.

Sandra Dross, of Seattle Children’s Research Institute in Washington, and colleagues analyzed a subset of infants from a larger study conducted in Mozambique who tested negative for HIV infection at birth and positive one month or later. They used DNA polymerase chain reaction to test for infection.

Nine of 24 infants included in the study exhibited nevirapine-resistant HIV-1 infection. Specimens taken from eight of these babies were 100% positive for resistant virus, according to the researchers. Seven infants had follow-up specimens available, and all showed continued high levels of resistant virus.

Infant age, maternal age and drug exposure appeared similar between those presenting with wild type and those with nevirapine-resistant infection, although researchers said the results may have been affected by the study’s high loss to follow-up rate, noting that one mother initiated antiretroviral therapy while breast-feeding, whereas other mothers did not receive ART while breast-feeding.

“We conclude that breast-feeding infants of single-dose nevirapine-exposed women are at considerable risk of infection with high concentrations of nevirapine-resistant virus that persists over time,” Dross said during the conference.

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