Prevention of mother-to-child HIV-1 transmission in Burkina Faso: evaluation of vertical transmission by PCR, molecular characterization of subtypes and determination of antiretroviral drugs resistance

Abstract

BackgroundVertical human immunodeficiency virus (HIV) transmission is a public health problem in Burkina Faso. The main objective of this study on the prevention of mother-to-child HIV-1 transmission was to determine the residual risk of HIV transmission in infants born to mothers receiving highly active antiretroviral therapy (HAART). Moreover, we detect HIV antiretroviral (ARV) drug resistance among mother–infant pairs and identify subtypes and circulating recombinant forms (CRF) in Burkina Faso.DesignIn this study, 3,215 samples of pregnant women were analyzed for HIV using rapid tests. Vertical transmission was estimated by polymerase chain reaction in 6-month-old infants born to women who tested HIV positive. HIV-1 resistance to ARV, subtypes, and CRFs was determined through ViroSeq kit using the ABI PRISM 3,130 sequencer.ResultsIn this study, 12.26% (394/3,215) of the pregnant women were diagnosed HIV positive. There was 0.52% (2/388) overall vertical transmission of HIV, with rates of 1.75% (2/114) among mothers under prophylaxis and 0.00% (0/274) for those under HAART. Genetic mutations were also isolated that induce resistance to ARV such as M184V, Y115F, K103N, Y181C, V179E, and G190A. There were subtypes and CRF of HIV-1 present, the most common being: CRF06_CPX (58.8%), CRF02_AG (35.3%), and subtype G (5.9%).ConclusionsARV drugs reduce the residual rate of HIV vertical transmission. However, the virus has developed resistance to ARV, which could limit future therapeutic options when treatment is needed. Resistance to ARV therefore requires a permanent interaction between researchers, physicians, and pharmacists, to strengthen the network of monitoring and surveillance of drug resistance in Burkina Faso.

Antiretroviral Treatment and Resistance Patterns in HIV-Infected Children

“…The study revealed genetic mutations that induce resistance such as M184V, Y115F, K103N, Y181C, V179E and G190A. The main strains of infection in this study group were CRF06_CPX and CRF02_AG [20].…”

“…Major resistance associated mutations in reverse transcriptase gene were observed in about one in three of the ART naïve and experienced children respectively while minor mutations were observed in protease gene in only five out of the total 140 children involved in the study [19]. Sagna et al [20] identified resistant strains to ARV drugs and determined the subtypes and circulating recombinant forms (CRF) of HIV-1 among mother-infant pairs in a study carried out in Burkina Faso. The study revealed genetic mutations that induce resistance such as M184V, Y115F, K103N, Y181C, V179E and G190A.…”

HIV-1 Variants and Drug Resistance in Pregnant Women from Bata (Equatorial Guinea): 2012-2013

“…Data on number of pregnancies or previously infected/exposed children from the 69 women were not available in clinical reports provided by GQ clinicians, but it is unlikely that these women were exposed to ART before participating in the PMTCT program. As most of the included 69 women were under ART at sampling leading to low VL, we were able to obtain resistance data from 38 women, representing 55.1% of the whole cohort, a high rate compared to other reports performed on treated pregnant women [38,48,49]. Following WHO recommendations for resistance testing in limited resources settings, we used DBS for sample collection (only four drops of eluted dried blood) to obtain the HIV sequence, whereas all resistance studies in pregnant women apart from one in Tanzania [43], were carried out on higher volumes of plasma or whole blood [38–42,44–51].…”

Qualitative Detection of Proviral-DNA of HIV-1 in Infants to Determine the Efficacy of Antiretroviral Therapy in the Prevention of Vertical Transmission of HIV-1 in The Gambia

“…The Human Immunodeficiency Virus (HIV) is an etiological cause of Acquired Immunodeficiency Syndrome (AIDS) [1] [2] [3] [4] which is a major worldwide threat particularly in Africa as it continues to claim millions of lives and still remind incurable. Globally, over 35.4 million people are living with the HIV and about 63% -70% of the HIV infected individuals at the end of 2012 are living in Sub-Saharan Africa [5] [6].…”

“…The Sub-Saharan Africa represent 10% of the world's population but unfortunately 67% of HIV infected adults and 90% of HIV infected children live in Sub-Saharan Africa and about three quarters of all AIDS deaths occurred in this region [7] [8]. It is estimated that roughly there are 7000 new HIV infections every day and nearly 97% of these, come from developing countries and about 60% are from Sub-Saharan Africa [4].…”