Effects of short-course zidovudine on the selection of nevirapine-resistant HIV-1 in women taking single-dose nevirapine

Abstract

Single-dose nevirapine (sdNVP) given to prevent mother-to-child- transmission of HIV-1 selects NVP-resistance. Short-course zidovudine (ZDV) was hypothesized to lower rates of NVP-resistance. HIV-1 infected pregnant women administered sdNVP with or without short-course ZDV were assessed for HIV-1 mutations (K103N, Y181C, G190A, and V106M) prior to delivery and postpartum. Postpartum NVP-resistance was lower among 31 taking ZDV+sdNVP compared to 33 taking only sdNVP (35.5 vs 72.7; χ 2 P =. 003). NVP mutants decayed to <2 in 24/35 (68.6) at a median 6 months postpartum, with no differences based on ZDV use (logrank P =. 99). Short-course ZDV was associated with reduced NVP-resistance mutations among women taking sdNVP. © 2012 The Author.