HIV-Positive Pregnant Women Who Receive Tenofovir Have Decreased Risk Of Developing Drug Resistance

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HIV-positive women who are pregnant and receive the antiretroviralstenofovir and emtricitabine during childbirth could reduce the risk ofdeveloping resistance to antiretroviral drugs, according to a studypublished Wednesday in the Lancet, AFP/Yahoo! News reports (AFP/Yahoo! News, 11/7).

For the study, Benjamin Chi of the University of Alabama-Birmingham and the Centre for Infectious Disease Researchin Zambia randomly assigned 400 HIV-positive pregnant women who soughtcare at two clinics in Lusaka, Zambia, to take either a single doseeach of tenofovir and emtricitabine or neither drug. The women all wereoffered nevirapine and short-course treatment with zidovudine,according to the study (Chi et al., Lancet, 11/7).

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Thestandard treatment to prevent mother-to-child transmission is toprovide a single dose of nevirapine during childbirth, which reducesthe risk of HIV transmission by 40%. However, the drug increasesinfants' risk of contracting a drug-resistant strain of HIV if thevirus is transmitted during birth. In addition, nevirapine increasesthe woman's risk of developing a drug-resistant strain of HIV (AFP/Yahoo! News, 11/7).

Womenassigned to take tenofovir and emtricitabine during childbirth were 53%less likely than women in the control group to have developed drugresistance six weeks after delivery, the study found. Women in thetenofovir-emtricitabine group had a 12% chance of developing drugresistance, compared with a 25% risk for the control group.

Fourwomen in each group experienced postpartum anemia, and 10% of infantsin the tenofovir-emtricitabine group and 12% in the control group hadadverse side effects, including septicemia and pneumonia, according tothe study (Lancet, 11/7). The researchers said the side effects likely were not the result of the new drug combination.

Related Commentary

Shahin Lockman and James McIntrye of the Harvard School of Public Healthin a commentary accompanying the study said the findings "providestrong evidence that adding single-dose tenofovir-emtricitabine" to thestandard method of preventing mother-to-child HIV transmission is a"new, effective and feasible approach to reducing maternal nevirapineresistance" (AFP/Yahoo! News, 11/7).

Reprinted with permission from kaisernetwork.org. You can view theentire Kaiser DailyHIV/AIDS Report, search the archives, and sign up for email delivery at kaisernetwork.org/email . The Kaiser Daily HIV/AIDS Report ispublished for kaisernetwork.org, a free service of The Henry J. Kaiser FamilyFoundation.

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