Factors Influencing HIV Drug Resistance among Pregnant Women in Luanda, Angola: Findings from a Cross-Sectional Study

Abstract

The increase in HIV infection and drug-resistant strains is an important public health concern, especially in resource-limited settings. However, the identification of factors related to the propagation of infectious diseases represents a crucial target offering an opportunity to reduce health care costs as well as deepening the focus on preventing infection in high-risk groups. In this study, we investigate the factors related to drug resistance among HIV-infected pregnant women in Luanda, the capital city of Angola. This was a part of a cross-sectional study conducted with 42 HIV-positive pregnant women. A blood sample was collected, and HIV-1 genotyping was carried out using an in-house method. Multivariate analyses were performed to determine the interaction between sociodemographic characteristics and drug resistance. HIV drug resistance was detected in 44.1% of the studied population. High probabilities of drug resistance were observed for HIV-infected pregnant women living in rural areas (AOR: 2.73; 95% CI: 0.50–14.9) with high educational level (AOR: 6.27; 95% CI: 0.77–51.2) and comorbidities (AOR: 5.47; 95% CI: 0.28–106) and infected with a HIV-1 non-B subtype other than subtype C (AOR: 1.60; 95% CI: 0.25–10.3). The present study reports high HIV drug resistance. Furthermore, older-age, rural areas, high educational levels, unemployed status, having comorbidities, and HIV-1 subtypes were factors related to drug resistance. These factors impact on drug susceptibility and need to be urgently addressed in order to promote health education campaigns able to prevent the spread of drug-resistant HIV strains in Angola.

Frequency of resistance to first-line antiretroviral therapy observed among HIV patients

“…Whereas Sebastião et al studied the factors influencing HIV drug resistance among pregnant females, they found a high frequency of drug resistance among the pregnant HIV females with other comorbidities, living in rural areas, and those with high educational status. 23 Similarly, other studies also confirm that patients' age, residence, education, occupational status, comorbid conditions, and HIV-1 subtypes are the significant factors related to ART failure. 24,25 Limitations of the Study: Among the major limitations of the present study was its crosssectional design and devoid generalizability; these outcomes cannot be generalized for the entire Pakistani population, as the study included only the HIV-positive patients from Peshawar attending the study site for treatment.…”

Seroprevalence and risk factors of STIs among rejected blood donors at the National Blood Transfusion Service in Angola

“…Previous studies have documented higher rates of STIs and other communicable diseases in Luanda, partly due to the high concentration of risk groups such as sex workers and injecting drug users. [28][29][30][31][32][33] Likewise, studies carried out in Ethiopia and Pakistan also showed that the majority of blood donation candidates with positive serology came from urbanized regions. [34,35] Although not statistically signi cant (p > 0.05), more than 95% of STI and 100% of multiple infections were observed in unmarried subjects, indicating that this group may serve as a potential source of STI dissemination (Table 1).…”

Long-term and low-level envelope C2V3 stimulation from highly diverse virus isolates leads to frequent development of broad and elite antibody neutralization in HIV-1 infected individuals

“…Subtypes A and C dominated over other subtypes but all other Env subtypes were present along with untypable basal strains and recombinant strains that prevailed over pure subtypes. The remarkable diversity and evolution of HIV-1 in Angola is driven by the increasing number of new infections 77 , the limited access to antiretroviral therapy, and high levels of drug resistance 46,78 .…”