Nevirapine, sodium concentration and HIV-1 RNA in breast milk and plasma among HIV-infected women receiving short-course antiretroviral prophylaxis

Kirsten Salado-Rasmussen; Zahra Persson Theilgaard; Mercy G. Chiduo; Ib Christian Bygbjerg; Jan Gerstoft; Margrethe Lüneborg-Nielsen; Martha M. Lemnge; Terese Lea Katzenstein

doi:10.1371/journal.pone.0121111

Nevirapine, sodium concentration and HIV-1 RNA in breast milk and plasma among HIV-infected women receiving short-course antiretroviral prophylaxis

Kirsten Salado-Rasmussen, Zahra Persson Theilgaard, Mercy G. Chiduo, Ib Christian Bygbjerg, Jan Gerstoft, Margrethe Lüneborg-Nielsen, Martha M. Lemnge, Terese Lea Katzenstein

Department of Clinical Medicine

2 Citations (Scopus)

Abstract

Introduction: Risk factors for breast milk transmission of HIV-1 from mother to child include high plasma and breast milk viral load, low maternal CD4 count and breast pathology such as mastitis. Objective: To determine the impact of nevirapine and subclinical mastitis on HIV-1 RNA in maternal plasma and breast milk after intrapartum single-dose nevirapine combined with either 1-week tail of Combivir (zidovudine/lamivudine) or single-dose Truvada (tenofovir/emtricitabine). Methods: Maternal plasma and bilateral breast milk samples were collected between April 2008 and April 2011 at 1, 4 and 6 weeks postpartum from HIV-infected Tanzanian women. Moreover, plasma samples were collected at delivery from mother and infant. Results: HIV-1 RNA was quantified in 1,212 breast milk samples from 273 women. At delivery, 96%of the women and 99%of the infants had detectable nevirapine in plasma with a median (interquartile range, IQR) of 1.5 μg/mL (0.75-2.20 μg/mL) and 1.04 μg/mL (0.39-1.71 μg/mL), respectively (P < 0.001). At 1 week postpartum, 93%and 98%of the women had detectable nevirapine in plasma and breast milk, with a median (IQR) of 0.13 μg/mL (0.13-0.39 μg/mL) and 0.22 μg/mL (0.13-0.34 μg/mL), respectively. Maternal plasma and breast milk HIV-1 RNA correlated at all visits (R = 0.48, R = 0.7, R = 0.59; all P = 0.01). Subclinical mastitis was detected in 67%of the women at some time during 6 weeks, and in 38%of the breast milk samples. Breast milk samples with subclinical mastitis had significantly higher HIV-1 RNA at 1, 4 and 6 weeks (all P < 0.05). Conclusion: After short-course antiretroviral prophylaxis, nevirapine was detectable in most infant cord blood samples and the concentration in maternal plasma and breast milk was high through week 1 accompanied by suppressed HIV-1 RNA in plasma and breast milk.

Original language	English
Article number	e0121111
Journal	P L o S One
Volume	10
Issue number	3
Pages (from-to)	1-13
Number of pages	13
ISSN	1932-6203
DOIs	https://doi.org/10.1371/journal.pone.0121111
Publication status	Published - 26 Mar 2015

Keywords

Faculty of Health and Medical Sciences

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1371/journal.pone.0121111

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Salado-Rasmussen, K., Theilgaard, Z. P., Chiduo, M. G., Bygbjerg, I. C., Gerstoft, J., Lüneborg-Nielsen, M., Lemnge, M. M., & Katzenstein, T. L. (2015). Nevirapine, sodium concentration and HIV-1 RNA in breast milk and plasma among HIV-infected women receiving short-course antiretroviral prophylaxis. P L o S One, 10(3), 1-13. [e0121111]. https://doi.org/10.1371/journal.pone.0121111

Nevirapine, sodium concentration and HIV-1 RNA in breast milk and plasma among HIV-infected women receiving short-course antiretroviral prophylaxis. / Salado-Rasmussen, Kirsten; Theilgaard, Zahra Persson; Chiduo, Mercy G. et al.

In: P L o S One, Vol. 10, No. 3, e0121111, 26.03.2015, p. 1-13.

Research output: Contribution to journal › Journal article › Research › peer-review

Salado-Rasmussen, K, Theilgaard, ZP, Chiduo, MG, Bygbjerg, IC , Gerstoft, J, Lüneborg-Nielsen, M, Lemnge, MM & Katzenstein, TL 2015, 'Nevirapine, sodium concentration and HIV-1 RNA in breast milk and plasma among HIV-infected women receiving short-course antiretroviral prophylaxis', P L o S One, vol. 10, no. 3, e0121111, pp. 1-13. https://doi.org/10.1371/journal.pone.0121111

@article{e46f59fa1dbc4e2fae5856b42bc5af88,

title = "Nevirapine, sodium concentration and HIV-1 RNA in breast milk and plasma among HIV-infected women receiving short-course antiretroviral prophylaxis",

abstract = "Introduction: Risk factors for breast milk transmission of HIV-1 from mother to child include high plasma and breast milk viral load, low maternal CD4 count and breast pathology such as mastitis. Objective: To determine the impact of nevirapine and subclinical mastitis on HIV-1 RNA in maternal plasma and breast milk after intrapartum single-dose nevirapine combined with either 1-week tail of Combivir (zidovudine/lamivudine) or single-dose Truvada (tenofovir/emtricitabine). Methods: Maternal plasma and bilateral breast milk samples were collected between April 2008 and April 2011 at 1, 4 and 6 weeks postpartum from HIV-infected Tanzanian women. Moreover, plasma samples were collected at delivery from mother and infant. Results: HIV-1 RNA was quantified in 1,212 breast milk samples from 273 women. At delivery, 96%of the women and 99%of the infants had detectable nevirapine in plasma with a median (interquartile range, IQR) of 1.5 μg/mL (0.75-2.20 μg/mL) and 1.04 μg/mL (0.39-1.71 μg/mL), respectively (P < 0.001). At 1 week postpartum, 93%and 98%of the women had detectable nevirapine in plasma and breast milk, with a median (IQR) of 0.13 μg/mL (0.13-0.39 μg/mL) and 0.22 μg/mL (0.13-0.34 μg/mL), respectively. Maternal plasma and breast milk HIV-1 RNA correlated at all visits (R = 0.48, R = 0.7, R = 0.59; all P = 0.01). Subclinical mastitis was detected in 67%of the women at some time during 6 weeks, and in 38%of the breast milk samples. Breast milk samples with subclinical mastitis had significantly higher HIV-1 RNA at 1, 4 and 6 weeks (all P < 0.05). Conclusion: After short-course antiretroviral prophylaxis, nevirapine was detectable in most infant cord blood samples and the concentration in maternal plasma and breast milk was high through week 1 accompanied by suppressed HIV-1 RNA in plasma and breast milk.",

keywords = "Faculty of Health and Medical Sciences, Nevirapine , HIV, breast milk",

author = "Kirsten Salado-Rasmussen and Theilgaard, {Zahra Persson} and Chiduo, {Mercy G.} and Bygbjerg, {Ib Christian} and Jan Gerstoft and Margrethe L{\"u}neborg-Nielsen and Lemnge, {Martha M.} and Katzenstein, {Terese Lea}",

year = "2015",

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doi = "10.1371/journal.pone.0121111",

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T1 - Nevirapine, sodium concentration and HIV-1 RNA in breast milk and plasma among HIV-infected women receiving short-course antiretroviral prophylaxis

AU - Salado-Rasmussen, Kirsten

AU - Theilgaard, Zahra Persson

AU - Chiduo, Mercy G.

AU - Bygbjerg, Ib Christian

AU - Gerstoft, Jan

AU - Lüneborg-Nielsen, Margrethe

AU - Lemnge, Martha M.

AU - Katzenstein, Terese Lea

PY - 2015/3/26

Y1 - 2015/3/26

N2 - Introduction: Risk factors for breast milk transmission of HIV-1 from mother to child include high plasma and breast milk viral load, low maternal CD4 count and breast pathology such as mastitis. Objective: To determine the impact of nevirapine and subclinical mastitis on HIV-1 RNA in maternal plasma and breast milk after intrapartum single-dose nevirapine combined with either 1-week tail of Combivir (zidovudine/lamivudine) or single-dose Truvada (tenofovir/emtricitabine). Methods: Maternal plasma and bilateral breast milk samples were collected between April 2008 and April 2011 at 1, 4 and 6 weeks postpartum from HIV-infected Tanzanian women. Moreover, plasma samples were collected at delivery from mother and infant. Results: HIV-1 RNA was quantified in 1,212 breast milk samples from 273 women. At delivery, 96%of the women and 99%of the infants had detectable nevirapine in plasma with a median (interquartile range, IQR) of 1.5 μg/mL (0.75-2.20 μg/mL) and 1.04 μg/mL (0.39-1.71 μg/mL), respectively (P < 0.001). At 1 week postpartum, 93%and 98%of the women had detectable nevirapine in plasma and breast milk, with a median (IQR) of 0.13 μg/mL (0.13-0.39 μg/mL) and 0.22 μg/mL (0.13-0.34 μg/mL), respectively. Maternal plasma and breast milk HIV-1 RNA correlated at all visits (R = 0.48, R = 0.7, R = 0.59; all P = 0.01). Subclinical mastitis was detected in 67%of the women at some time during 6 weeks, and in 38%of the breast milk samples. Breast milk samples with subclinical mastitis had significantly higher HIV-1 RNA at 1, 4 and 6 weeks (all P < 0.05). Conclusion: After short-course antiretroviral prophylaxis, nevirapine was detectable in most infant cord blood samples and the concentration in maternal plasma and breast milk was high through week 1 accompanied by suppressed HIV-1 RNA in plasma and breast milk.

AB - Introduction: Risk factors for breast milk transmission of HIV-1 from mother to child include high plasma and breast milk viral load, low maternal CD4 count and breast pathology such as mastitis. Objective: To determine the impact of nevirapine and subclinical mastitis on HIV-1 RNA in maternal plasma and breast milk after intrapartum single-dose nevirapine combined with either 1-week tail of Combivir (zidovudine/lamivudine) or single-dose Truvada (tenofovir/emtricitabine). Methods: Maternal plasma and bilateral breast milk samples were collected between April 2008 and April 2011 at 1, 4 and 6 weeks postpartum from HIV-infected Tanzanian women. Moreover, plasma samples were collected at delivery from mother and infant. Results: HIV-1 RNA was quantified in 1,212 breast milk samples from 273 women. At delivery, 96%of the women and 99%of the infants had detectable nevirapine in plasma with a median (interquartile range, IQR) of 1.5 μg/mL (0.75-2.20 μg/mL) and 1.04 μg/mL (0.39-1.71 μg/mL), respectively (P < 0.001). At 1 week postpartum, 93%and 98%of the women had detectable nevirapine in plasma and breast milk, with a median (IQR) of 0.13 μg/mL (0.13-0.39 μg/mL) and 0.22 μg/mL (0.13-0.34 μg/mL), respectively. Maternal plasma and breast milk HIV-1 RNA correlated at all visits (R = 0.48, R = 0.7, R = 0.59; all P = 0.01). Subclinical mastitis was detected in 67%of the women at some time during 6 weeks, and in 38%of the breast milk samples. Breast milk samples with subclinical mastitis had significantly higher HIV-1 RNA at 1, 4 and 6 weeks (all P < 0.05). Conclusion: After short-course antiretroviral prophylaxis, nevirapine was detectable in most infant cord blood samples and the concentration in maternal plasma and breast milk was high through week 1 accompanied by suppressed HIV-1 RNA in plasma and breast milk.

KW - Faculty of Health and Medical Sciences

KW - Nevirapine

KW - HIV

KW - breast milk

U2 - 10.1371/journal.pone.0121111

DO - 10.1371/journal.pone.0121111

M3 - Journal article

C2 - 25812161

SN - 1932-6203

VL - 10

SP - 1

EP - 13

JO - PLoS Computational Biology

JF - PLoS Computational Biology

IS - 3

M1 - e0121111

ER -

Nevirapine, sodium concentration and HIV-1 RNA in breast milk and plasma among HIV-infected women receiving short-course antiretroviral prophylaxis

Abstract

Keywords

UN SDGs

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