The prevention of mother-to-child transmission (PMTCT) of HIV remains a critical issue in resource-limited settings as they strive to prevent a new generation of infants born with HIV; approximately 420,000 children were infected with HIV in 2007 alone.¹ The administration of a single dose of nevirapine (sdNVP), a nonnucleoside reverse transcriptase inhibitor (NNRTI), to the mother during labor has been demonstrated to be a safe and effective means of reducing vertical transmission of HIV.^2–6 This approach is an integral component of PMTCT in many developing nations and is particularly valuable when HIV-positive mothers are not identified early enough to receive more effective chemoprophylaxis regimens for PMTCT.
HIV-1 drug resistance mutations have been detected at low frequencies after single-dose nevirapine (sdNVP) for prevention of mother-to-child transmission (PMTCT). We investigated the relationship between these “minor variant” NVP-resistant viruses and clinical outcome with NVP-containing antiretroviral therapy (ART).