Vertical Transmission of Multidrug‐Resistant Human Immunodeficiency Virus Type 1 (HIV‐1) and Continued Evolution of Drug Resistance in an HIV‐1–Infected Infant

2001/06/01 by Victoria A. Johnson, Victoria A. Johnson, Christos J. Petropoulos +11 · 6 citations
Immunology and Microbiology · Medicine · #Biology #Didanosine #Drug resistance #Gene #Genetics #HIV Research and Treatment #HIV/AIDS Research and Interventions #HIV/AIDS drug development and treatment #Lentivirus #Long terminal repeat #Polymerase chain reaction #Provirus #Reverse transcriptase #Transmission (telecommunications) #Viral disease #Viremia #Virology #Virus #Zidovudine

paper · pdf · doi:10.1086/320697

openalex publication_date 2001/06/01 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01

Abstract

To confirm the vertical transmission of multidrug-resistant (MDR) human immunodeficiency virus type 1 (HIV-1) and to assess its impact on further evolution of drug-resistant virus in an infant, proviral DNA amplified from infected peripheral blood mononuclear cell cultures was sequenced to identify reverse transcriptase (RT) and protease (PR) mutations. The infant had proviral DNA with evidence of RT mutations (M41L, L74V, and T215Y) and 3 PR substitutions (K20R, M36I, and V82A). After delivery, the mother's proviral DNA had the same substitutions. Phylogenetic analyses of these HIV-1 RT and PR sequences indicated epidemiological linkage. Plasma drug susceptibility was determined by using a recombinant virus assay. Plasma HIV-1 obtained after the infant's birth demonstrated reduced susceptibility to zidovudine and ritonavir. Thus, vertical transmission of MDR HIV-1 was demonstrated in the setting of detectable maternal plasma viremia. Further accumulation of broad MDR in the infant's virus to 3 antiretroviral classes occurred, despite postnatal therapy.

Cited by

• Adherence to antiretrovirals among US women during and after pregnancy. [europepmc]
• Perinatal acquisition of drug-resistant HIV-1 infection: mechanisms and long-term outcome. [europepmc]
• Postpartum antiretroviral drug resistance in HIV-1-infected women receiving pregnancy-limited antiretroviral therapy. [europepmc]
• Molecular mechanisms of HIV-1 mother-to-child transmission and infection in neonatal target cells. [europepmc]
• Single Genome Analysis for the Detection of Linked Multiclass Drug Resistance Mutations in HIV-1-Infected Children After Failure of Protease Inhibitor-Based First-Line Therapy. [europepmc]
• Recognising and managing increased HIV transmission risk in newborns. [europepmc]

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