@article {Desai419, author = {N Desai and M Mathur}, title = {Selective transmission of multidrug resistant HIV to a newborn related to poor maternal adherence}, volume = {79}, number = {5}, pages = {419--421}, year = {2003}, doi = {10.1136/sti.79.5.419}, publisher = {The Medical Society for the Study of Venereal Disease}, abstract = {Objectives: To report perinatal transmission of multidrug resistant (MDR) HIV related to variable maternal adherence antenatally. Methods: Case study including review of clinic records, adherence information, laboratory data, and HIV genotyping results in mother and infant. Results: Poor maternal adherence to clinic visits and antiretroviral therapy contributed to detectable viraemia antenatally. When tested for the first time at age 6 months, the infant was found to have virus with resistance to multiple drugs. In this case, prophylaxis with zidovudine (AZT) failed to prevent the transmission of the MDR strain. Conclusions: Perinatal transmission of MDR HIV can occur despite standard peripartum prophylaxis with AZT. Perinatal prophylaxis should be tailored to the mother{\textquoteright}s treatment history and resistance profile. Paediatric HIV specialists should be prepared to deal with a small, but slowly increasing number of babies with a {\textquotedblleft}nightmare{\textquotedblright} multidrug resistant virus with limited treatment options.}, issn = {1368-4973}, URL = {https://sti.bmj.com/content/79/5/419}, eprint = {https://sti.bmj.com/content/79/5/419.full.pdf}, journal = {Sexually Transmitted Infections} }