Table 3.
Individual Subjects with Resistance-Associated Mutations (RAMs) Identified at Enrollment and/or at 6–12 weeks Postpartum in Plasma or PBMC Specimens
| |
|
ARV regimens during pregnancy |
CD4 and viral load testing |
RAMs—plasma specimens |
RAMs—PBMC specimens |
|||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Subject | Deliverya | ARV regimenb | Starta | Stopa | Duration (days) | Visit (timing)c | CD4+cnt/% | Viral load (copies/mL) | Enrolld | 6–12 weeksd | Enrolld | 6–12 weeksd |
| 1 | 38.4 | None | 0.1 | 13.7 | 96 | Enrl (37.4) | 418/40 | 4,685 | NT | K70R | NT | NT |
| 3TC, NVP, ZDV | 13.9 | 39.3 | 179 | HD (38.6) | 846/45 | |||||||
| None | 39.3 | 48.7 | 67 | 6–12 (48.7) | 729/34 | 3,140 | ||||||
| 2 | 38.0 | None | 0.1 | 25.7 | 180 | Enrl (32.0) | 348/30 | 646 | NT | K70R | NT | K70R |
| 3TC, NVP, ZDV | 25.9 | 38.9 | 92 | HD (38.1) | 503/24 | 228 | ||||||
| None | 38.9 | 44.0 | 37 | 6–12 (44.0) | 446/18 | 61,115 | ||||||
| 3 | 39.1 | None | 0.1 | 23.7 | 166 | Enrl (33.0) | 261/51 | 82 | NT | K70R | K70R | NT |
| 3TC, NVP, ZDV | 23.9 | 39.1 | 108 | HD (40.0) | 238/50 | |||||||
| None | 39.1 | 47.0 | 56 | 6–12 (47.0) | 156/22 | |||||||
| 4 | 41.0 | None | 0.1 | 27.3 | 191 | Enrl (34.0) | 554/41 | 400 | NT | M184V | None | None |
| 3TC, ZDV | 27.4 | 31.0 | 26 | HD (41.3) | 516/40 | 400 | ||||||
| 3TC, NVP, ZDV | 31.1 | 43.0 | 84 | 6–12 (47.9) | 473/29 | 11,400 | ||||||
| 3TC, ZDVe | 43.1 | 43.4 | 3 | |||||||||
| None | 43.4 | 47.9 | 32 | |||||||||
| 5 | 38.3 | None | 0.1 | 20.1 | 141 | Enrl (36.0) | 430/38 | 6,760 | K70R | None | NT | None |
| 3TC, ZDV | 20.3 | 35.0 | 104 | HD (38.7) | 677/41 | 508 | ||||||
| 3TC, NVP, ZDV | 35.1 | 41.0 | 42 | 6–12 (45.9) | 535/36 | 11,800 | ||||||
| 3TC, ZDVe | 41.1 | 41.4 | 3 | |||||||||
| None | 41.4 | 45.9 | 32 | |||||||||
| 6 | 40.3 | None | 0.1 | 31.3 | 219 | Enrl (34.0) | 507/31 | 478 | NT | K103N | NT | None |
| ZDV | 31.4 | 32.1 | 6 | HD (40.7) | 623/35 | |||||||
| 3TC, NVP, ZDV | 32.3 | 43.1 | 77 | 6–12 (49.9) | 616/34 | 16,400 | ||||||
| None | 43.1 | 49.9 | 48 | |||||||||
| 7 | 37.7 | None | 0.1 | 27.0 | 189 | Enrl (36.0) | 327/25 | 3,670 | NT | K103N | K70R | None |
| ZDV | 27.1 | 37.1 | 71 | HD (38.1) | 447/25 | |||||||
| 3TC, NVP, ZDV | 37.3 | 40.0 | 20 | 6–12 (43.9) | 524/32 | 4,710 | ||||||
| 3TC, ZDVe | 40.1 | 40.4 | 3 | |||||||||
| None | 40.4 | 43.9 | 25 | |||||||||
| 8 | 40.0 | None | 0.1 | 26.0 | 182 | Enrl (23.0) | 858/42 | 198,000 | K70R | NT | K70R, M461 | K70R, D30N |
| 3TC, NVP, ZDV | 26.1 | 43.0 | 119 | Ante (34.0) | 772/59 | 950 | ||||||
| NVPe | 43.1 | 43.4 | 3 | HD (40.3) | 879/55 | |||||||
| None | 43.4 | 45.9 | 18 | 6–12 (45–9) | 684/51 | 11,300 | ||||||
| 9 | 39.0 | None | 0.1 | 25.0 | 175 | Enrl (26.0) | 465/35 | 554 | NT | M184V | K70R | M184V |
| 3TC, NVP, ZDV | 25.1 | 30.1 | 36 | Ante (34.0) | 458/39 | |||||||
| None | 30.3 | 32.0 | 13 | HD (39.3) | 721/36 | |||||||
| 3TC, NVP, ZDV | 32.0 | 44.9 | 91 | 6–12 (44.9) | 709/34 | 2,010 | ||||||
| 10 | 38.0 | None | 0.1 | 20.4 | 143 | Enrl (35.7) | 613/41 | 50 | NT | K70R | NT | NT |
| 3TC, NVP, ZDV | 20.6 | 30.9 | 73 | HD (39.4) | 854/45 | 50 | ||||||
| 3TC, NVP, d4T | 31.0 | 38.1 | 51 | 6–12 (44.7) | 650/38 | 11,557 | ||||||
| NVPe | 38.3 | 38.9 | 5 | |||||||||
| None | 38.9 | 44.7 | 42 | |||||||||
| 11 | 35.4 | None | 0.1 | 23.6 | 165 | Enrl (25.1) | 330/30 | 7,792 | NT | D67N, K70R, K219Q, M41L, V82A | NT | NT |
| 3TC, NFV, ZDV | 23.7 | 35.6 | 84 | Ante (35.1) | 207/25 | |||||||
| None | 35.6 | 43.1 | 54 | HD (35.9) | 326/30 | 106 | ||||||
| 6–12 (43.1) | 311/26 | 21,255 | ||||||||||
| 12 | 40.1 | None | 0.1 | 18.0 | 126 | Enrl (28.0) | 462/39 | 155 | M46I | None | NT | NT |
| ZDV | 18.1 | 24.0 | 42 | Ante (34.0) | 535/44 | |||||||
| 3TC, NFV, ZDV | 24.1 | 40.3 | 114 | HD (40.3) | 317/22 | |||||||
| None | 40.3 | 49.0 | 62 | 6–12 (49.0) | 448/21 | 14,213 | ||||||
| 13 | 40.1 | None | 0.1 | 22.0 | 154 | Enrl (25.0) | 469/NA | NT | V179D | V179D | NT | |
| 3TC, NVP, ZDV | 22.1 | 25.1 | 22 | Ante (34.0) | 697/58 | |||||||
| 3TC, ZDV | 25.3 | 25.3 | 1 | HD (40.4) | 715/51 | 60 | ||||||
| ZDV | 25.4 | 40.6 | 107 | 6–12 (47.7) | 585/32 | 3,443 | ||||||
| None | 40.6 | 47.7 | 51 | |||||||||
| 14 | 37.9 | None | 0.1 | 13.7 | 96 | Enrl (36.0) | 649/NA | 6,167 | D30N, K103N, M184V, V108I | D30N, K103N, M184V, V108I | None | D30N, K103N, M184V, V108I, V75I |
| 3TC, NFV, ZDV | 13.9 | 40.9 | 190 | HD (38.0) | 457/NA | 11,290 | ||||||
| None | 40.9 | 48.0 | 51 | 6–12 (48.0) | 635/40 | 5,961 | ||||||
| 15 | 39.4 | None | 0.1 | 26.7 | 187 | Enrl (31.0) | 551/39 | 227 | L210W, M41L, (E44D and V118I) | NT | L210W, M41L, (E44D and V118I) | L210W, M41L, (E44D V118I), D67N |
| 3TC, NFV, ZDV | 26.9 | 39.4 | 89 | HD (39.7) | 896/NA | |||||||
| None | 39.4 | 48.0 | 61 | 6–12 (48.0) | 538/36 | |||||||
| 16 | 38.7 | None | 0.1 | 24.6 | 172 | Enrl (30.0) | 165/24 | 5,620 | NT | M184V | None | M184V |
| 3TC, ZDV | 24.7 | 44.3 | 138 | HD (39.0) | 167/23 | 44,000 | ||||||
| None | 44.3 | 48.0 | 27 | 6–12 (48.0) | 105/21 | 75,000 | ||||||
| 17 | 40.7 | None | 0.1 | 29.9 | 209 | Enrl (33.0) | 806/45 | NT | M41L | NT | NT | |
| 3TC, ZDV | 30.0 | 40.9 | 77 | HD (41.0) | 398/44 | |||||||
| None | 40.9 | 49.0 | 58 | 6–12 (49.0) | 655/36 | 6,810 | ||||||
| 18 | 37.7 | None | 0.1 | 23.9 | 167 | Enrl (33.0) | 436/29 | 5,790 | NT | M184V | None | NT |
| 3TC, ZDV | 24.0 | 43.3 | 136 | HD (38.0) | 348/26 | 14,100 | ||||||
| None | 43.3 | 50.0 | 48 | 6–12 (50.0) | 389/24 | 7,910 | ||||||
| 19 | 39.7 | None | 0.1 | 25.9 | 181 | Enrl (19.0) | 311/26 | 2,050 | NT | M46I | NT | None |
| 3TC, NVP, ZDV | 26.0 | 40.0 | 99 | Ante (33.0) | 360/30 | |||||||
| None | 40.0 | 47.7 | 55 | HD (40.0) | 402/29 | 61 | ||||||
| 6–12 (47.7) | 445/28 | 1,001 | ||||||||||
| 20 | 39.1 | None | 0.1 | 30.1 | 211 | Enrl (30.0) | 1119/38 | 1,610 | V108I | NT | NT | NT |
| 3TC, ZDV | 30.3 | 39.7 | 67 | HD (40.0) | 1170/43 | |||||||
| None | 39.7 | 52.0 | 87 | 6–12 (52.0) | 979/38 | 1,371 | ||||||
| 21 | 43.1 | None | 0.1 | 22.9 | 160 | Enrl (12.0) | 336/20 | 31,967 | M46I | None | NT | NT |
| 3TC, ZDV | 23.0 | 33.3 | 73 | Ante (21.9) | 336/21 | 47,806 | ||||||
| 3TC, NFV, ZDV | 33.4 | 43.4 | 71 | Ante (32.0) | 490/31 | 3,711 | ||||||
| None | 43.4 | 52.0 | 61 | HD (43.9) | 866/37 | 1,886 | ||||||
| 6–12 (52.0) | 407/18 | 95,623 | ||||||||||
| 22 | 37.7 | None | 0.1 | 12.7 | 89 | Enrl (22.0) | 747/37 | NT | V179D | NT | NT | |
| 3TC, NFV, ZDV | 12.9 | 37.7 | 175 | Ante (32.7) | 736/46 | |||||||
| None | 37.7 | 46.7 | 64 | HD (38.0) | 656/40 | |||||||
| 6–12 (46.7) | 806/36 | 6,460 | ||||||||||
| 23 | 40.0 | None | 0.1 | 28.0 | 196 | Enrl (35.0) | 926/33 | 83 | NT | NT | NT | L33F |
| 3TC, NVP, ZDV | 28.1 | 40.1 | 85 | HD (40.3) | 573/36 | 54,340 | ||||||
| None | 40.1 | 47.0 | 49 | 6–12 (47.0) | 501/23 | 8,908 | ||||||
| 24 | 37.1 | None | 0.1 | 19.3 | 135 | Enrl (37.0) | 232/30 | NT | NT | K70R | K70R | |
| 3TC, NVP, ZDV | 19.4 | 37.1 | 125 | HD (37.3) | 240/33 | |||||||
| None | 37.1 | 44.1 | 50 | 6–12 (44.1) | 288/34 | |||||||
| 25 | 36.3 | None | 0.1 | 18.0 | 126 | Enrl (27.0) | 343/25 | 44,900 | NT | NT | NT | K70R |
| ZDV | 18.1 | 30.1 | 85 | Ante (34.0) | 428/38 | 597 | ||||||
| 3TC, NVP, ZDV | 30.3 | 36.9 | 47 | HD (37.3) | 925/42 | 400 | ||||||
| 3TC, ZDVe | 37.0 | 37.3 | 3 | 6–12 (42.9) | 494/25 | 37,000 | ||||||
| None | 37.3 | 42.9 | 40 | |||||||||
| 26 | 37.6 | None | 0.1 | 26.0 | 182 | Enrl (27.0) | 403/31 | NT | NT | K70R | K70R | |
| 3TC, NVP, ZDV | 26.1 | 40.0 | 98 | Ante (33.0) | 351/36 | |||||||
| 3TC, ZDVe | 40.1 | 40.4 | 3 | HD (37.9) | 717/32 | |||||||
| None | 40.4 | 43.9 | 25 | 6–12 (43.9) | 490/35 | 556 | ||||||
| 27 | 38.0 | None | 0.1 | 33.6 | 235 | Enrl (38.0) | 556/29 | 2,280 | NT | NT | NT | K70R |
| 3TC, ZDV | 33.7 | 38.1 | 32 | HD (38.3) | 597/22 | 13,500 | ||||||
| None | 38.1 | 47.1 | 64 | 6–12 (47.1) | 3100/59 | 23,700 | ||||||
| 28 | 29.9 | None | 0.1 | 28.0 | 196 | Enrl (27.0) | 245/21 | 379,193 | NT | NT | G190A | None |
| ZDV | 28.1 | 29.9 | 13 | HD (30.6) | 441/22 | 7,651 | ||||||
| None | 29.9 | 40.0 | 72 | 6–12 (40.0) | 468/30 | 175,785 | ||||||
| 29 | 37.7 | None | 0.1 | 18.9 | 132 | Enrl (18.0) | 196/23 | 3,524 | NT | NT | M46I | None |
| 3TC, ZDV | 19.0 | 37.9 | 133 | Ante (34.0) | 380/24 | 101 | ||||||
| None | 37.9 | 45.9 | 57 | HD (38.0) | 372/35 | 162 | ||||||
| 6–12 (45.9) | 299/20 | 3,823 | ||||||||||
| 30 | 40.7 | None | 0.1 | 18.4 | 129 | Enrl (26.0) | 301/35 | 5,900 | NT | NT | K103N, M184V, V108I | K103N |
| 3TC, NFV, ZDV | 18.6 | 33.9 | 108 | Ante (34.3) | 373/33 | 496 | ||||||
| IDV, TDF, d4T | 34.0 | 42.1 | 58 | HD (40.9) | 446/36 | 418 | ||||||
| None | 42.1 | 47.3 | 37 | 6–12 (47.3) | 288/32 | 28,300 | ||||||
| 31 | 39.1 | None | 0.1 | 18.7 | 131 | Enrl (20.0) | 440/16 | 3,400 | NT | NT | NT | K70R |
| 3TC, NFV, ZDV | 18.9 | 39.3 | 144 | Ante (32.0) | 292/24 | |||||||
| None | 39.3 | 45.7 | 46 | HD (39.3) | 588/26 | |||||||
| 6–12 (45.7) | 398/14 | 54,900 | ||||||||||
| 32 | 31.0 | None | 0.1 | 21.7 | 152 | Enrl (31.0) | 587/33 | NT | NT | NT | K103N | |
| 3TC, NFV, ZDV | 21.9 | 31.1 | 66 | HD (31.7) | 323/34 | 4,320 | ||||||
| None | 31.1 | 42.7 | 82 | 6–12 (42.7) | 309/26 | 60,000 | ||||||
a
Delivery date and start and stop of ARV use during pregnancy are given in weeks of gestation.
b
“None” used to denote periods during pregnancy (through 6–12 week postpartum visit) when no ARVs were received.
c
Visit and timing (in weeks of gestation) corresponding to available CD4+ count, CD4+ percent and viral load (HIV-1 RNA) measures. Visits: Enrl = enrollment; Ante = antepartum visit; HD = hospital discharge; and 6–12 = 6–12 week postpartum visit.
d
NT = sample not tested for resistance; None = no resistance associated mutations were detected. Where resistance associated mutations were detected, the specific codon substitutions are identified.
e
ARVs started after delivery.