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Occurrence of HIV-1 reverse transcriptase gene mutation at codon 215 in HIV-infected infants
G Kamkamidze1, T Sullivan, T Charbonneau
1Wadsworth Center for Laboratories and Research, New York State Department of Health, Albany, NY, USA.
Summary
Zidovudine (ZDV) resistance mutations in HIV-1 are increasing in infants, particularly those born later. This rise correlates with increased maternal ZDV treatment, potentially impacting ZDV prophylaxis effectiveness.
Area of Science:
- Virology
- Infectious Diseases
- Pediatrics
Background:
- Zidovudine (ZDV) prophylaxis reduces mother-to-child HIV transmission but is not fully effective.
- Failure of ZDV prophylaxis may stem from transmission of ZDV-resistant HIV strains.
Purpose of the Study:
- To determine the prevalence of codon 215 mutations in HIV-1 strains from infected infants.
- To associate these mutations with infant clinical status and viral load.
Main Methods:
- Analyzed DNA from 49 HIV-1 infected infants using nested PCR for codon 215 mutations.
- Measured HIV-1 viral load in plasma using RNA PCR (Roche Amplicor Monitor assay).
Main Results:
- 24.5% of infants had HIV strains with codon 215 mutations.
- Mutation frequency increased significantly from 6.3% (1992-1994) to 33.3% (1998-1999).
- Higher viral loads and maternal ZDV treatment correlated with increased ZDV resistance mutations.
Conclusions:
- ZDV-resistant HIV strains are more frequent in infants, especially in recent years.
- Increased maternal ZDV use may contribute to the rise in resistant strains.
- The impact of ZDV resistance on preventing vertical HIV transmission requires further investigation.