Nevirapine-resistant HIV present in breastmilk of a third of women exposed to single dose (Aidsmap)

A third of women who take single-dose nevirapine (Viramune) to prevent mother-to-child transmission of HIV have virus resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs) present in their breastmilk eight weeks after giving birth, according to a study published in the October 1st edition of Clinical Infectious Diseases (now online). The investigators also found that almost three quarters of women had detectable HIV in their breastmilk and that women with mastitis – breast tissue inflammation – had significantly higher levels of HIV shedding, leading the researchers to recommend that “interventions to reduce mastitis…are warranted, to increase the safety of breast-feeding and prevent breastmilk transmission of HIV.”

It is estimated that over 600,000 infants were infected with HIV via mother-to-child transmission in sub-Saharan Africa in 2003, and that a third of these infections were due to breast-feeding. Mastitis has been associated with increased viral load in breastmilk and a higher risk of mother-to-child transmission.

Although single-dose nevirapine has been shown to substantially reduce mother-to-child transmission, there is a significant risk that HIV resistance to drugs in the NNRTI class will evolve.


click to read more...