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AIDS. 2015 Jul 31;29(12):1467-71. doi: 10.1097/QAD.0000000000000737.

Resistance detected by pyrosequencing following zidovudine monotherapy for prevention of HIV-1 mother-to-child-transmission.

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aUniversity of Washington bSeattle Children's Research Institute, Seattle, Washington, USA cInstitut de Recherche pour le Développement (IRD) UMI 174-PHPT, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand dHarvard School of Public Health, Boston, Massachusetts eTulane University School of Medicine, New Orleans, Louisiana, USA.


To prevent mother-to-child-transmission of HIV-1, the 2010 WHO guidelines recommended prenatal zidovudine (ZDV) monotherapy (option A). To determine if ZDV monotherapy selects for HIV resistance in antiretroviral-naive women during pregnancy, specimens from 50 individuals were examined using pyrosequencing. ZDV-resistance mutations were detected at delivery in seven women (14%, 95% confidence interval 6.6-26.5%). These data raise the question whether women administered ZDV monotherapy for prevention of mother-to-child-transmission could have higher risk of virologic failure when later started on combination antiretroviral therapy, as has been demonstrated following single-dose nevirapine prophylaxis.

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