Surveillance of Transmitted Drug-Resistant HIV Among Young Pregnant Women in Ouagadougou, Burkina Faso

Somda, Antoine; Sangaré, Lassana; Soro, Monique; Yameogo, Saydou; Bazie, Babou; Bigirimana, F.; Bertagnolio, Silvia; Peeters, Martine; Mouacha, Fatima; Rivera, Ana María; Jordan, Michael R.; Sanou, Marie-Joseph

doi:10.1093/cid/cir988

Cited by 10 publications

(7 citation statements)

References 17 publications

(12 reference statements)

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“…Therefore, resistance mutation to NRTIs is the most frequent form of drug resistance, as found in previous studies. Recent studies those conducted in sub‐Saharan Africa had reported a higher trend of primary HIV‐1 drug resistance [Hamers et al, 2011; Hunt et al, 2012; Sigaloff et al, 2012; Somda et al, 2012]. For PI‐associated mutations, the rate of resistance observed was lower than in previous reports from resource‐rich areas.…”

Section: Discussionmentioning

confidence: 80%

HIV‐1 drug resistance‐associated mutations among antiretroviral‐naive thai patients with chronic HIV‐1 infection

Manosuthi

Thongyen

Nilkamhang

et al. 2012

Journal of Medical Virology

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Antiretroviral therapy (ART) has increased in resource-limited settings. This study determined the prevalence of HIV-1 drug resistance-associated mutations (DRAMs) among patients with chronic HIV-1 infections and compare DRAMs between CRF01_AE and B subtypes. ART-naive Thai patients who had ART initiation between 2010 and 2011 were enrolled prospectively. Genotypic assays were performed on viral reverse transcriptase and protease genes within 4 weeks before starting ART. DRAMs were assessed using the International AIDS Society-USA 2011 list. A total of 330 patients were included. HIV-1 subtypes included CRF01_AE (73%), B (23.9%), and others (3.1%). Median (IQR) CD4+ was 66 (23-172) cells/mm(3) and median (IQR) HIV-1 RNA was 5.2 (4.6-5.8) log copies/ml. The prevalence of patients with ≥1 DRAMs for any antiretroviral agents was 17.6%. DRAM prevalence was 17% for non-nucleoside reverse transcriptase inhibitors (NNRTIs), 0.6% for NRTIs, and 0.6% for protease inhibitors (PIs). DRAMs to NNRTIs were V106I (7%), V179D (4.2%), V179T (1.8%), E138A (1.5%), V90I (1.2%), K103N (0.9%), Y181C (0.9%), and P225H (0.3%). DRAMs to NRTIs were M184V (0.3%) and T215S (0.3%). The only major DRAM for PIs was M46L (0.6%). Minor DRAMs to PIs including I13V, M36I, H69K, and L89M were observed more frequently in CRF_01 AE. By multivariate analysis, the factors "HIV-1 subtype B" and "low pretreated CD4+ cell count" were associated with a higher rate of DRAMs. HIV-1 DRAMs, especially to NNRTIs, are emerging in a middle-income country after widespread use of NNRTI-based ART. HIV genotypic assays before ART initiation in patients with chronic HIV-1 infection should be considered.

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Section: Discussionmentioning

confidence: 80%

HIV‐1 drug resistance‐associated mutations among antiretroviral‐naive thai patients with chronic HIV‐1 infection

Manosuthi

Thongyen

Nilkamhang

et al. 2012

Journal of Medical Virology

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“…Previous studies in West Africa have found low levels of pretreatment DR in Guinea, moderate levels in Mali and levels varying from low to moderate in Cape Verde [ 39 – 43 ]. Levels of pretreatment DR in pregnant women were low in studies from Ghana and Nigeria, while moderate levels were observed in Burkina Faso [ 44 – 46 ]. Our study, which was performed twelve years after ART roll out in Guinea Bissau, found levels of pretreatment DR higher than the above mentioned studies, a difference that may be associated with the time of the studies after national ART scale up in the countries [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of HIV-1 pretreatment drug resistance among treatment naïve pregnant women in Bissau, Guinea Bissau

et al. 2018

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BackgroundWith 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.MethodsTreatment-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.ResultsForty 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.ConclusionOur 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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“…Therefore, resistance mutation to NRTIs is the most frequent form of drug resistance, as found in previous studies. Recent studies those conducted in sub-Saharan Africa had reported a higher trend of primary HIV-1 drug resistance [Hamers et al, 2011;Hunt et al, 2012;Sigaloff et al, 2012;Somda et al, 2012]. For PI-associated mutations, the rate of resistance observed was lower than in previous reports from resource-rich areas.…”

Section: Discussionmentioning

confidence: 60%

HIV‐1 drug resistance‐associated mutations among antiretroviral‐naïve Thai patients with chronic HIV‐1 infection

Manosuthi

Thongyen

Nilkamhang

et al. 2012

Journal of the International AIDS Society

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Purpose of study Antiretroviral therapy (ART) has been scaled up in resource‐limited settings. This study aimed to determine the prevalence of HIV‐1 drug resistance‐associated mutations (DRAMs) among patients with chronic HIV‐1 infection and to compare DRAMs between CRF01_AE and B subtypes. Methods ART‐naïve Thai patients who were indicated for ART initiation between 2010 and 2011 were prospectively enrolled. Genotypic assays of reverse transcriptase and protease genes were performed within 4 weeks prior to ART. DRAMs were assessed using International AIDS Society USA 2011 list. Summary of results A total of 330 patients were included. HIV‐1 subtypes included CRF01_AE (241, 73.0%), B (79, 23.9%), and others (10, 3.1%). Median (IQR) CD4 was 66 (23–172) cells/mm3 and median (IQR) HIV‐1 RNA was 5.2 (4.6–5.8) log copies/mL. The prevalence of patients with≥1 DRAMs to any antiretroviral agents was 17.6%; 17.0% to NNRTIs, 0.6% to NRTIs, and 0.6% to protease inhibitors (PIs). V106I (23, 7.0%), V179D (14, 4.2%), V179T (6, 1.8%), E138A (5, 1.5%), V90I (4, 1.2%), K103N (3, 0.9%), Y181C (3, 0.9%), and P225H (1, 0.3%) were DRAMs to NNRTIs. M184V (1, 0.3%) and T215S (1, 0.3%) were DRAMs to NRTIs. M46L (2, 0.6%) was the only major DRAM to PI. Minor DRAMs to PIs including I13V, M36I, H69K, and L89M were more frequently observed in CRF_01 AE but A71V/T and V77I were more common in subtype B (P < 0.05). By multivariate analysis, the factors ‘HIV‐1 subtype B’ and ‘low pretreated CD4 cell count’ were associated with higher rate of DRAMs. Conclusion HIV‐1 DRAMs, especially to NNRTIs, is emerging in a middle‐income country after a widespread use of NNRTI‐based ART. HIV genotypic assay prior to ART initiation in patients with chronic HIV‐1 infection should be considered.

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Surveillance of Transmitted Drug-Resistant HIV Among Young Pregnant Women in Ouagadougou, Burkina Faso

Cited by 10 publications

References 17 publications

HIV‐1 drug resistance‐associated mutations among antiretroviral‐naive thai patients with chronic HIV‐1 infection

HIV‐1 drug resistance‐associated mutations among antiretroviral‐naive thai patients with chronic HIV‐1 infection

Prevalence of HIV-1 pretreatment drug resistance among treatment naïve pregnant women in Bissau, Guinea Bissau

HIV‐1 drug resistance‐associated mutations among antiretroviral‐naïve Thai patients with chronic HIV‐1 infection

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