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J Acquir Immune Defic Syndr. 2013 Aug 15;63(5):572-7. doi: 10.1097/QAI.0b013e31829308f8.

No clinically significant drug-resistance mutations in HIV-1 subtype C-infected women after discontinuation of NRTI-based or PI-based HAART for PMTCT in Botswana.

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*Botswana-Harvard AIDS Institute Partnership for HIV Research and Education, Gaborone, Botswana; †Department of Pathology, School of Medicine, University of Botswana, Gaborone, Botswana; ‡Harvard University, Cambridge, MA; §Department of Medicine and Pediatrics, Massachusetts General Hospital, Boston, MA; ‖Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA; ¶Department of Medicine, Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA; and #Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA.


Risk of developing drug resistance after stopping antiretroviral regimens to prevent mother-to-child HIV-1 transmission is unknown. The Mma Bana Study randomized treatment-naive pregnant women with CD4 ≥200 cells per cubic millimeter to receive either abacavir/zidovudine/lamivudine [triple nucleoside reverse transcriptase inhibitor (NRTI) arm] or lopinavir/ritonavir/zidovudine/lamivudine [protease inhibitor (PI) arm]. Drugs were discontinued after 6 months of breastfeeding. One month after discontinuation, 29 NRTI arm samples and 25 PI arm samples were successfully genotyped. No clinically significant antiretroviral resistance mutations were detected. Eight minor resistance mutations were found among 11 (20%) women (3 from NRTI arm and 8 from PI arm), occurring at similar frequencies to those reported in HIV-1 subtype C treatment-naive cohorts.

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