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Relating CYP2B6 genotype and efavirenz resistance among post-partum women living with HIV with high viremia in Uganda: a nested cross-sectional study

Background: We investigated the association between CYP2B6 polymorphisms and efavirenz drug resistance among women living with HIV who started on antiretroviral therapy during pregnancy and with high viremia during post-partum.

Methods: This was a cross-sectional study of women with viral loads greater than 1000 copies/ml who were at least 6 weeks postpartum. Sanger sequencing was used to detect resistant mutations, as well as host genotyping, and efavirenz resistance was compared among the metabolizer genotypes.

Results: Over the course of one year (July 2017-July 2018), 322 women were screened, with 110 (34.2%) having viral loads of 1000 copies/ml and 62 having whole blood available for genotyping. Fifty-nine of these women had both viral resistance and human host genotypic results. Efavirenz resistance according to metabolizer genotype was; 47% in slow, 34% in extensive and 28% in intermediate metabolizers, but the difference was not statistically significant due to the small sample size.

Conclusions: There was no statistically significant difference in EFV resistance between EFV metabolizer genotypes in women who started antiretroviral therapy during pregnancy and had high viremia in the postpartum period. However, a numerical trend was discovered, which calls for confirmation in a large, well-designed, statistically powered study.

Comments：

The study investigated the association between CYP2B6 polymorphisms and efavirenz drug resistance among women living with HIV who started on antiretroviral therapy during pregnancy and had high viremia in the postpartum period. A total of 322 women were screened over one year, with 110 having viral loads greater than 1000 copies/ml and 62 having whole blood available for genotyping. Among these, 59 women had both viral resistance and human host genotypic results available. Efavirenz resistance was compared among the metabolizer genotypes and it was found that there was no statistically significant difference in EFV resistance between EFV metabolizer genotypes in this population. However, a numerical trend was observed, which calls for further confirmation in a large, well-designed, statistically powered study. The study was cross-sectional in nature and used Sanger sequencing to detect resistant mutations and host genotyping.

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Cat.No. Product Name Information
S4685 Efavirenz Efavirenz is a synthetic non-nucleoside reverse transcriptase (RT) inhibitor with antiviral activity.

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Reverse Transcriptase