A Case of in utero Transmission of Drug-resistant HIV in the United States

Thanks to the development of antiretroviral drugs and the implementation of routine perinatal prophylaxis, primarily containing zidovudine, modern-day rates of perinatal transmission of HIV are very low in developed countries. We present a case of perinatal transmission of HIV with extensive nucleoside reverse transcriptase inhibitor resistance as a reminder that perinatal transmission of resistance mutations can occur. This case calls for further investigation into the utility of using genotype to determine neonatal prophylaxis in the setting of maternal HIV drug resistance.

Automated summary

Thanks to antiretroviral drugs and routine perinatal prophylaxis, perinatal transmission of HIV is very low in developed countries. However, this case highlights the possibility of perinatal transmission of resistance mutations and calls for further investigation into using genotype for neonatal prophylaxis in the presence of maternal HIV drug resistance.