Prevalence of HIV-1 pretreatment drug resistance among treatment naïve pregnant women in Bissau, Guinea Bissau
Wilhelmson, Sten LU ; Månsson, Fredrik LU ; Lopatko Lindman, Jacob LU ; Biai, Ansu ; Esbjörnsson, Joakim LU
; Norrgren, Hans
LU
; Jansson, Marianne
LU
and Medstrand, Patrik
LU
(2018)
In PLoS ONE
13(10).
p.0206406-0206406
- Abstract
BACKGROUND: With increased access to antiretroviral treatment (ART) in sub-Saharan Africa emergence of HIV-1 pretreatment drug resistance constitutes a serious risk. This may lead to rapid virological failure in subjects initiating ART, and mother-to-child transmission despite prophylaxis.
METHODS: Treatment-naïve pregnant women from four antenatal care clinics in Bissau, Guinea-Bissau, were enrolled from October 2016 to November 2017. Genotypic resistance testing and phylogenetic subtype analysis was performed on 48 specimens.
RESULTS: Forty eight women met the survey inclusion criteria. All specimens were successfully amplified and genotyped. Specimens from five women were associated with HIV-1 drug resistance mutations.... (More)
BACKGROUND: With increased access to antiretroviral treatment (ART) in sub-Saharan Africa emergence of HIV-1 pretreatment drug resistance constitutes a serious risk. This may lead to rapid virological failure in subjects initiating ART, and mother-to-child transmission despite prophylaxis.
METHODS: Treatment-naïve pregnant women from four antenatal care clinics in Bissau, Guinea-Bissau, were enrolled from October 2016 to November 2017. Genotypic resistance testing and phylogenetic subtype analysis was performed on 48 specimens.
RESULTS: Forty eight women met the survey inclusion criteria. All specimens were successfully amplified and genotyped. Specimens from five women were associated with HIV-1 drug resistance mutations. Four carried mutations exclusively linked to non-nucleoside reverse transcriptase inhibitors (NNRTIs) (K103N, K103N/S) and one carried mutations to both NNRTIs (G190S, K101E) and nucleoside reverse transcriptase inhibitors (NRTIs) (M184V). These results corresponded to 10.4% (95% CI: 4.5-22.2%), 2.1% (95% CI: 0.4-10.9%) and 0% (95% CI: 0.0-7.4%) drug resistance mutations to NNRTIs, NRTIs and protease inhibitors, respectively. HIV-1 circulating recombinant form 02AG was most commonly found, followed by HIV-1 sub-subtype A3. Subtype/CRF was not associated with drug resistance mutations.
CONCLUSION: Our study reports a 10.4% prevalence of pretreatment drug resistance to NNRTIs in HIV-1-infected pregnant women in the capital Bissau, Guinea Bissau. Since NNRTIs are part of first-line ART in the country, baseline resistance screenings or adjustment of national treatment guidelines should be considered as antiretroviral treatment programs are scaled up.
(Less)
- author
- Wilhelmson, Sten
LU
; Månsson, Fredrik
LU
; Lopatko Lindman, Jacob
LU
; Biai, Ansu
; Esbjörnsson, Joakim
LU
; Norrgren, Hans
LU
; Jansson, Marianne
LU
and Medstrand, Patrik
LU
- author collaboration
- organization
- publishing date
- 2018-10-31
- type
- Contribution to journal
- publication status
- published
- subject
- in
- PLoS ONE
- volume
- 13
- issue
- 10
- pages
- 0206406 - 0206406
- publisher
- Public Library of Science (PLoS)
- external identifiers
-
- scopus:85055773439
- pmid:30379960
- ISSN
- 1932-6203
- DOI
- 10.1371/journal.pone.0206406
- language
- English
- LU publication?
- yes
- id
- 6ca5bb36-303d-4414-b64f-86dc1e5814b9
- date added to LUP
- 2018-11-19 14:30:53
- date last changed
- 2024-03-02 12:21:10
@article{6ca5bb36-303d-4414-b64f-86dc1e5814b9,
abstract = {{<p>BACKGROUND: With increased access to antiretroviral treatment (ART) in sub-Saharan Africa emergence of HIV-1 pretreatment drug resistance constitutes a serious risk. This may lead to rapid virological failure in subjects initiating ART, and mother-to-child transmission despite prophylaxis.</p><p>METHODS: Treatment-naïve pregnant women from four antenatal care clinics in Bissau, Guinea-Bissau, were enrolled from October 2016 to November 2017. Genotypic resistance testing and phylogenetic subtype analysis was performed on 48 specimens.</p><p>RESULTS: Forty eight women met the survey inclusion criteria. All specimens were successfully amplified and genotyped. Specimens from five women were associated with HIV-1 drug resistance mutations. Four carried mutations exclusively linked to non-nucleoside reverse transcriptase inhibitors (NNRTIs) (K103N, K103N/S) and one carried mutations to both NNRTIs (G190S, K101E) and nucleoside reverse transcriptase inhibitors (NRTIs) (M184V). These results corresponded to 10.4% (95% CI: 4.5-22.2%), 2.1% (95% CI: 0.4-10.9%) and 0% (95% CI: 0.0-7.4%) drug resistance mutations to NNRTIs, NRTIs and protease inhibitors, respectively. HIV-1 circulating recombinant form 02AG was most commonly found, followed by HIV-1 sub-subtype A3. Subtype/CRF was not associated with drug resistance mutations.</p><p>CONCLUSION: Our study reports a 10.4% prevalence of pretreatment drug resistance to NNRTIs in HIV-1-infected pregnant women in the capital Bissau, Guinea Bissau. Since NNRTIs are part of first-line ART in the country, baseline resistance screenings or adjustment of national treatment guidelines should be considered as antiretroviral treatment programs are scaled up.</p>}},
author = {{Wilhelmson, Sten and Månsson, Fredrik and Lopatko Lindman, Jacob and Biai, Ansu and Esbjörnsson, Joakim and Norrgren, Hans and Jansson, Marianne and Medstrand, Patrik}},
issn = {{1932-6203}},
language = {{eng}},
month = {{10}},
number = {{10}},
pages = {{0206406--0206406}},
publisher = {{Public Library of Science (PLoS)}},
series = {{PLoS ONE}},
title = {{Prevalence of HIV-1 pretreatment drug resistance among treatment naïve pregnant women in Bissau, Guinea Bissau}},
url = {{http://dx.doi.org/10.1371/journal.pone.0206406}},
doi = {{10.1371/journal.pone.0206406}},
volume = {{13}},
year = {{2018}},
}