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

Abstract

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.

Molecular Epidemiology of HIV-1 Infected Migrants Followed Up in Portugal: Trends between 2001–2017

“…Between 2010 and 2017, EFV and 3TC were recommended for first line treatment in Portugal. This was also the most frequent NRTI and NNRTI-resistance mutation (M184V and K103N) among pre-treated patients and was previously reported among antiretroviral-naïve patients living in Portuguese Speaking countries [38,40,41]. A low prevalence of TDR to PIs within migrants reflects the scarce administration of this antiretroviral as first line in their countries of origin.…”

The HIV care continuum and HIV-1 drug resistance among female sex workers: a key population in Guinea-Bissau

“…Similarly to our study, the report from South Africa included both FSW on treatment, FSW reporting treatment discontinuation, and treatment naïve FSW. The most common resistance mutation in the ART naïve FSW was the K103N and K103S mutations, which is similar to a recent study of pregnant women in Guinea Bissau [25]. The prevalence of PDR was high, especially in the second part of the study were the prevalence reached 13.8% although with a large uncertainty of the estimate.…”

“…The qPCR assay had a limit of quantification of five RNA copies/qPCR reaction with a linear range between 10 6 and 5 RNA copies/reaction. HIV-1 drug resistance genotyping were determined as follows: HIV-1 RNA was extracted from blood plasma, and HIV-1 pol sequences were amplified by RT-PCR and nested PCR as described [25]. The final length of all the HIV-1 pol sequences following removal of regions corresponding to the primers, editing and alignment was 1035 bases, corresponding to nucleotide positions 2268-3302 of HXB2 (GenBank accession number K03455), covering positions 6-99 of the protease and positions 1-251 of the reverse transcriptase regions.…”

“…This increase was mostly driven by increasing levels of non-nucleoside reverse transcriptase inhibitors (NNRTI) resistance which are currently used in many sub-Saharan countries as first-line ART regimens for HIV-1, including Guinea-Bissau [15]. A recent study of HIV-1 infected pregnant women in Guinea-Bissau reported a 10.4% prevalence of PDR to NNRTI [18]. There is currently little information on the HIV care continuum from diagnosis to viral suppression and emergence of HIVDR among FSW in West Africa.…”

sierra-local: A lightweight standalone application for drug resistance prediction

“…In addition, we retrieved 7 population-based HIV-1 pol datasets from Genbank using the NCBI PopSet interface (http://www.ncbi.nlm.nih.gov/popset). These datasets were selected from the most recent uploads of substantial numbers of HIV-1 sequences covering the regions encoding both PR and RT, and representing a diversity of HIV-1 subtypes and sampling locations around the world (Arimide et al, 2018;Rasmussen et al, 2018;Wilhelmson et al, 2018). All resistance scores for all 1,006 sequences were completely concordant between the pipelines.…”