Rates of HBV, HCV, HDV and HIV type 1 among pregnant women and HIV type 1 drug resistance-associated mutations in breastfeeding women on antiretroviral therapy

Abstract

BackgroundHBV, HCV, HDV and HIV are blood borne and can be transmitted from mother-to-child. Reports of HBV infection rates show up to 11.9% in Cameroon while for HCV, the rate is less than 2%. More so, as pregnant women get enrolled in the HIV PMTCT Programme and stay in the care continuum, selection of HIV-1 drug resistant strains is evident. We sought to determine the seroprevalence of HBV, HCV, HDV and HIV among pregnant women, assess their knowledge, attitudes and practices on transmission and prevention of HBV infection, and determine HIV drug resistance profile of breastfeeding women.MethodsA serosurvey of HBV, HCV, HDV and HIV was carried out among 1005 pregnant women in Yaounde, Cameroon. In 40 HIV-infected breastfeeding women enrolled in the PMTCT Programme, HIV-1 genotypes and HIV-1 resistance to NRTIs, NNRTIs and PIs, were determined by phylogeny and the Stanford University HIV Drug Resistance interpretation tool, respectively.ResultsAmong the pregnant women, the rates of HIV-1, HBV, HCV and HDV infections were 8.5, 6.4, 0.8 and 4.0%, respectively. About 5.9% of the women knew their HBV status before pregnancy unlike 63.7% who knew their HIV status. Although 83.3% reported that vaccination against HBV infection is a method of prevention, and 47.1% knew that HBV could be transmitted from mother-to-child, only 2.5% had received the Hepatitis B vaccine. Of the 40 women on antiretroviral therapy (ART), 9 had at least one major resistance-associated mutation (RAM, 22.5%) to NRTI, NNRTI or PI. Of these M184 V (12.5%), K70R (10.0%), K103 N (12.5%), Y181C (10.0%), M46 L (2.5%) and L90 M (2.5%) were most frequently identified, suggesting resistance to lamivudine, nevirapine, efavirenz and zidovudine. Eighty four percent were infected with HIV-1 recombinant strains with CRF02_AG predominating (50%).ConclusionsThe rates of HBV and HIV-1 infections point to the need for early diagnosis of these viruses during pregnancy and referral to care services in order to minimize the risk of MTCT. Furthermore, our results would be useful for evaluating the HIV PMTCT Programme and Treatment Guidelines for Cameroon.Electronic supplementary materialThe online version of this article (10.1186/s12884-018-2120-7) contains supplementary material, which is available to authorized users.

Resistance rates among antiretroviral regimens in pregnant people living with HIV

“…This study showed high rates of NNRTI mutations, with K103N being the most prevalent, followed by NRTI mutations, with M184V/I being the most prevalent, which is in accordance with a prior study at our centre [4]. Similarly, in studies of PPLH in Cameroon and the Bahamas, rates of antiretroviral resistance were highest against NNRTI (EFV and NVP) and NRTI [lamivudine (3TC) and zidovudine (ZDV)] [10,11]. In the WHO report [5], the overall prevalence of resistance among ART-naïve women living with HIV was 14.2% to NNRTI, 7.7% to NRTIs, 0.4% to PIs and 0.3% to INSTIs; the overall pretreatment resistance to second-generation NNRTIs was in the range 0.5-13.2% for doravirine (DOR), 1-10.3% for etravirine (ETR) and 2.4-18.7% for rilpivirine (RPV) [5].…”

“…According to the 2022 International Antiviral Society (IAS)‐USA Drug Resistance Mutation Update, the magnitude of the reduction in susceptibility varies considerably, with those defined as major mutations most closely related to premature treatment failure and associated with significant reductions in susceptibility [8]. Our finding of high prevalence of K103N is similar to other studies [5, 10–12]. Among the participants in this study with E138A/G/K/Q mutations, all of them had subtype B.…”

“…studies [5,[10][11][12]. Among the participants in this study with E138A/G/K/Q mutations, all of them had subtype B.…”

Co-infection and Risk Factors Associated with STIs among Pregnant Women in Rural Health Facilities in Nigeria: A Retrospective Study

“…In Federal Ministry of Health (FMOH) and World Health Organization report, Nigeria has a high burden of hepatitis C at a prevalence rate of 2.0%, 17 hence women that received antenatal health care in the AMURT supported rural health facilities in Ebonyi state have a high HCV prevalence rate. This is higher than the findings of other studies in Nigeria which were: 2.6% in Enugu, 35 0.8% in Edo State, 37 0.5% in Niger delta, 45 1.1% in Okada, Edo state, 46 0.8% among Cameroonian women, 56 and 1.8% in Southern Ethiopia. 54 The result is lower than the findings outside Nigeria in places like Western Ethiopia where HCV prevalence of 8.1%.…”

Underestimated Prevalence of HIV, Hepatitis B Virus (HBV), and Hepatitis D Virus (HDV) Triple Infection Globally: Systematic Review and Meta-analysis

“…HBV and HDV are common viruses for coinfection in people living with HIV, as all 3 share the same route of infection [ 14 , 35 ]. Studies have shown that HIV coinfection with HBV and HDV is widespread in various regions of the world, but the coinfection rate varies among countries and regions [ 36 ]. HIV coinfection with HBV or HDV can cause more serious damage to the body than a single infection, and the harm of triple infection is even more serious.…”