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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.

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author
organization
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publication status
published
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in
PLoS ONE
volume
13
issue
10
pages
0206406 - 0206406
publisher
Public Library of Science
external identifiers
  • scopus:85055773439
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
2019-01-06 14:16:07
@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       = {,  and 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},
  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},
  volume       = {13},
  year         = {2018},
}