{"id":14269,"date":"2010-12-01T10:35:27","date_gmt":"2010-12-01T10:35:27","guid":{"rendered":"http:\/\/i-base.info\/htb\/?p=14269"},"modified":"2012-07-26T12:29:54","modified_gmt":"2012-07-26T12:29:54","slug":"minority-m184v-variants-detected-in-women-after-receiving-3tcftc-and-lpvr-containing-regimens-in-pregnancy","status":"publish","type":"post","link":"https:\/\/i-base.info\/htb\/14269","title":{"rendered":"Minority M184V variants detected in women after receiving 3TC\/FTC and LPV\/r-containing regimens in pregnancy"},"content":{"rendered":"<p><strong>Polly Clayden, HIV i-Base<\/strong><\/p>\n<p>Short-term antiretroviral therapy (START) of two NRTIs and a ritonavir boosted PI is used frequently to prevent mother to child transmission in the UK. Resistance is rarely detected using standard genotyping following this strategy.<\/p>\n<p>Sabrina Surah and colleagues conducted a multicentre study to determine whether minority M184V variants emerge with 3TC\/FTC and LPV\/r containing START regimens in pregnancy, and, if so, whether this has an impact on future treatment success.<\/p>\n<p>The investigators used an allele-specific real time PCR (ASPCR), optimised for subtypes B, C and AG, to detect minority M184V variants. This assay has a lower limit of detection of 0.5%.<\/p>\n<p>Plasma samples were tested pre and post treatment and routine population based sequencing (Viroseq) was also performed.<\/p>\n<p>Samples from 38 women were tested and ASPCR failed in 15 (39%). Of the remaining 23 women, 16 (42%) had wild type (WT) virus and 7 (18%) had minority M184V sequences with a range of detection between 0.5% and 14%. The investigators noted that all samples were WT with population-based sequencing.<\/p>\n<p>ASPCR failed to amplify from pre- treatment samples in 4\/7 women with minority M184V and was WT in 3. Therapeutic drug monitoring of lopinavir was performed in a subset of women.<\/p>\n<p>The investigators found no difference in prior ART, duration of START, drug concentration of LPV\/r or virological suppression with subsequent ART in women with or without mutations. There were more women with subtype C among those with M184V mutations, 5\/7 (62%) than those with WT, 1\/16 (6%).<\/p>\n<p>The investigators suggested that the possible association with HIV-1 subtype C requires further evaluation and a clade effect on acquisition of resistance has been reported following nevirapine use in pregnancy. <\/p>\n<h2>comment<\/h2>\n<p><strong>That there was no difference in subsequent virological suppression between women with minority M184V mutations after START regimens is reassuring. <\/strong><\/p>\n<p>Reference:<\/p>\n<p>Surah S et al.: Minority M184V variants in women exposed to 3TC\/FTC-containing lopinavir-ritonavir (LPVr) regimens in pregnancy. 10th International Congress on Drug Therapy in HIV Infection, November 7-11. Glasgow. Poster 159. Published in Journal of the International AIDS Society 2010 13(Suppl4):P159. <a href=\"http:\/\/www.jiasociety.org\/content\/13\/S4\/P159\">http:\/\/www.jiasociety.org\/content\/13\/S4\/P159<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Polly Clayden, HIV i-Base Short-term antiretroviral therapy (START) of two NRTIs and a ritonavir boosted PI is used frequently to prevent mother to child transmission in the UK. Resistance is rarely detected using standard genotyping following this strategy. Sabrina Surah &hellip;<\/p>\n","protected":false},"author":4,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[4,35,36],"tags":[80],"class_list":["post-14269","post","type-post","status-publish","format-standard","hentry","category-conference-reports","category-pmtct-and-maternal-health","category-drug-resistance","tag-hiv-10-glasgow-2010"],"_links":{"self":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/14269","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/users\/4"}],"replies":[{"embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/comments?post=14269"}],"version-history":[{"count":0,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/posts\/14269\/revisions"}],"wp:attachment":[{"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/media?parent=14269"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/categories?post=14269"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/i-base.info\/htb\/wp-json\/wp\/v2\/tags?post=14269"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}