{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T07:42:41Z","timestamp":1791013361981,"version":"4.1.0"},"reference-count":25,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Epidemiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antiretroviral drugs for preventing mother-to-child transmission (PMTCT) can lead to NRTI resistance in infants who contract HIV despite prophylaxis. We aimed to assess how different post-natal prophylaxis (PNP) strategies; nevirapine (NVP) alone vs zidovudine (ZDV) alone vs dual NVP\u2009+\u2009ZDV influenced NRTI resistance prevalence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from nationally representative HIV drug resistance surveys conducted in Kenya where the standard practice was the use of dual NVP\u2009+\u2009ZDV and Nigeria where the standard practice was the use of NVP PNP. HIV drug resistance was determined using population-based sequencing, and mutations interpreted using the Stanford HIVdb algorithm. Analyses were weighted for multistage sampling and genotyping success rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 557 HIV-infected infants aged &amp;lt;18 months with data on resistance and type of PNP, 29.3% received dual NVP\u2009+\u2009ZDV PNP, 24.6% received NVP alone, 2.3% received ZDV alone, and 43.8% received no PNP. The prevalence of NRTI resistance was 19.4% (95%CI 15.2\u201324.3) in Nigeria and 9.6% (95%CI 6.6\u201313.8) in Kenya (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u20090.001). Resistance to abacavir, lamivudine, zidovudine and tenofovir were 2- to 4.5-fold higher in Nigerian HIV infected infants exposed to NVP PNP compared to Kenyan infants exposed to NVP\u2009+\u2009ZDV. The proportion of infants with NNRTI resistance was 49% (95%CI 43.5\u201354.5) and 43.8% (95%CI 38.0\u201349.7), in Nigeria and Kenya respectively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.204).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings suggest an association between type of PNP and the development of NRTI resistance in HIV-infected infants. Dual-drug prophylaxis was associated with a low prevalence of NRTI resistance compared to single-drug PNP. Our findings highlight the need for further research on combination prophylactic strategies in minimizing the emergence of drug resistance in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fepid.2026.1887821","type":"journal-article","created":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T06:02:22Z","timestamp":1787724142000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Association between infant post-natal prophylaxis regimens and pretreatment HIV drug resistance in infected infants"],"prefix":"10.3389","volume":"6","author":[{"given":"Seth C.","family":"Inzaule","sequence":"first","affiliation":[{"name":"Amsterdam Institute for Global Health and Development , and Department of Global Health, Amsterdam UMC, University of Amsterdam","place":["Amsterdam, 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Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilly","family":"Nyagah","sequence":"additional","affiliation":[{"name":"National AIDS and STI Control Programme, Ministry of Health","place":["Nairobi, Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Onwonga","sequence":"additional","affiliation":[{"name":"Kenya National Public Health Institute, Ministry of Health","place":["Nairobi, Kenya"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Penazzato","sequence":"additional","affiliation":[{"name":"World Health Organization","place":["Geneva, Switzerland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Bertagnolio","sequence":"additional","affiliation":[{"name":"World Health Organization","place":["Geneva, 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