HIV drug-resistant and nonsubtype B strains increasingly common in perinatally infected

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IV drug-resistant and nonsubtype B strains are becoming increasingly common in perinatally infected infants in New York State.

According to a recently published study from the United States, “Prevalence studies indicate that transmission of drug-resistant HIV has been rising in the adult population, but data from the perinatally infected pediatric population are limited.

“In this retrospective study, we sequenced the pol region of HIV from perinatally infected infants diagnosed in New York State in 2001-2002. Analyses of drug resistance, subtype diversity, and perinatal antiretroviral exposure were conducted, and the results were compared with those from a previous study of HIV-infected infants identified in 1998-1999.”

"Eight of 42 infants (19.1%) had provirus carrying at least 1 drug-resistance mutation, an increase of 58% over the 1998-1999 results. Mutations conferring resistance to nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, and protease inhibitors were detected in 7.1, 11.9, and 2.4% of specimens, respectively.

“Consistent with previous results,” reported M. Karchava and colleagues at the New York State Department of Health, Wadsworth Center, “perinatal antiretroviral exposure was not associated with drug resistance (p=0.70). Phylogenetic analysis indicated that 16.7% of infants were infected with a nonsubtype B strain of HIV.”

The authors concluded, “It seems that drug-resistant and nonsubtype B strains of HIV are becoming increasingly common in the perinatally infected population.

“Our results highlight the value of resistance testing for all HIV-infected infants upon diagnosis and the need to consider subtype diversity in diagnostic and treatment strategies.”

Karchava and colleagues published their study in Journal of Acquired Immune Deficiency Syndromes (Prevalence of drug-resistance mutations and nonsubtype B strains among HIV-infected infants from New York State. J Acquir Immune Defic Syndr, 2006;42(5):614-619).

Additional information can be obtained by contacting M.M. Parker, NYSDOH, Wadsworth Center, David Axelrod Institute, POB 22002, Albany, NY 12201, USA.

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