Breast-milk shedding of drug-resistant HIV-1 subtype C in women exposed to single-dose nevirapine

Esther J. Lee, Rami Kantor, Lynn Zijenah, Wayne Sheldon, Lynda Emel, Patrick Mateta, Elizabeth Johnston, Jennifer Wells, Avinash K. Shetty, Hoosen Coovadia, Yvonne Maldonado, Samuel Adeniyi Jones, Lynne M. Mofenson, Christopher H. Contag, Mary Bassett, David A. Katzenstein

Research output: Contribution to journalArticlepeer-review

47 Citations (Scopus)


Single-dose nevirapine reduces intrapartum human immunodeficiency virus 1 type (HIV-1) transmission but may also select for nonnucleoside reverse-transcriptase inhibitor (NNRTI) resistance in breast milk (BM) and plasma. Among 32 Zimbabwean women, median 8-week postpartum plasma and BM HIV-1 RNA levels were 4.57 and 2.13 log10 copies/ mL, respectively. BM samples from women with laboratory-diagnosed mastitis (defined as elevated BM Na+ levels) were 5.4-fold more likely to have HIV-1 RNA levels above the median. BM RT sequences were not obtained for 12 women with BM HIV-1 RNA levels below the lower limit of detection of the assay used. In 20 paired BM and plasma samples, 65% of BM and 50% of plasma RT sequences had NNRTI-resistance mutations, with divergent mutation patterns.

Original languageEnglish
Pages (from-to)1260-1264
Number of pages5
JournalJournal of Infectious Diseases
Issue number7
Publication statusPublished - 01-09-2005
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Public Health, Environmental and Occupational Health
  • Immunology


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