Short Communication: Prevalence of HIV-1 Transmitted Drug Resistance in Liberia

Abstract

No data on HIV-transmitted drug resistance (TDR) are available in Liberia in which the HIV prevalence in the general population is estimated at 1.5%. The aim of the study was to assess the prevalence of TDR in HIV-1 from recently diagnosed and untreated patients living in Monrovia, Liberia. The study was performed in the John F. Kennedy Medical Center and in the Redemption Hospital, both located in Monrovia. All newly HIV-1 diagnosed patients attending voluntary counseling testing centers and antiretroviral therapy naive were consecutively included. Protease and reverse transcriptase (RT) regions sequencing was performed using the ANRS procedures (www.hivfrenchresistance.org). Drug resistance mutations (DRM) were identified according to the 2009 updated WHO surveillance DRM list. Among the 116 HIV-1-infected patients enrolled in the study, 85 (73%) were women. Protease and RT sequencing was successful in 109 (94%) and 102 (88%) samples, respectively. Seventy-five (66%) patients were infected with CRF02_AG. One DRM was observed in six samples, leading to a TDR prevalence of 5.9% (CI 95%=1.7-10.1). DRM were observed in two patients (2.0%; CI 95%=0.0-4.7), four patients (3.9%; CI 95%=0.1-7.7), and one patient (0.9%; CI 95%=0.0-2.7) for nucleoside RT inhibitors (NRTI), non-NRTI (NNRTI), and protease inhibitors, respectively. Overall, one patient exhibited dual class-resistant viruses, harboring NRTI and NNRTI resistance mutations (1.0%; CI 95%=0.0-2.9). This first survey study in Liberia reported a TDR prevalence of 5.9%, classified as moderate according to the WHO criteria, indicating that further surveillance is warranted to follow the level and evolution of TDR prevalence in recently HIV-1 diagnosed patients.

Surveillance of transmitted HIV-1 antiretroviral drug resistance in the context of decentralized HIV care in Senegal and the Ebola outbreak in Guinea

“…The 0% TDR prevalence found in Senegal comforts previous studies from this site that reported no NNRTIs mutations and, a decline in NRTIs TDR (4.16–0%) between 1998 and 2006/2007 [ 10 , 22 ]. This extremely low rate is contrary to that observed in a meta-analysis showing a 3.5% rate at 5–7 years after ART rollout in WCA [ 23 ] and, in Liberia (Monrovia) in 2013 (5.9%) [ 24 ]. Such stable prevalence most likely reflects substantial inputs from AIDS control programs to minimize HIV risky behaviors.…”

Prevalence of drug resistance mutations among ART-naive and -experienced HIV-infected patients in Sierra Leone

“…Two earlier studies by Loubet et al 9 , 15 . conducted in neighbouring Liberia just before the onset of the Ebola epidemic (2013) had found a PDR prevalence rate of 5.7% in ART-naive patients ( n = 116) 15 and RAM prevalences of 63% and 71% to NRTIs and NNRTIs, respectively, in ART-experienced patients ( n = 90) 9 . Thus, our study provides the first major update on HIVDR in the three most affected countries in the immediate post-Ebola period.…”

“…As indicated earlier, HIVDR has been a growing public health problem in West Africa in recent years 8–12 and is likely to have been further exacerbated by the considerable disruptions in HIV services in Sierra Leone, Guinea and Liberia (the three most affected countries) during the Ebola epidemic of 2014–16 14 . Two earlier studies by Loubet et al 9 , 15 . conducted in neighbouring Liberia just before the onset of the Ebola epidemic (2013) had found a PDR prevalence rate of 5.7% in ART-naive patients ( n = 116) 15 and RAM prevalences of 63% and 71% to NRTIs and NNRTIs, respectively, in ART-experienced patients ( n = 90) 9 .…”

Prevalence of Pretreatment and Acquired HIV-1 Mutations Associated with Resistance to Lamivudine or Rilpivirine: A Systematic Review

“…The estimated global prevalence of pretreatment DRMs was 4% (n=2,719/60,567; range, 2% [Asia Pacific] to 6% [North America]) for those associated with NRTI resistance [16,18,25,28,[30][31][32][35][36][37][38]40,43,44,46,48,49,[51][52][53][54][55][56][57][58][59][60] and 6% (n=3,605/61,402; range, 3% [Asia Pacific] to 8% [Africa and North America]) for those associated with resistance to any NNRTI (Figure 1) [16,18,25,28,[30][31][32][33][34][35][36][37][38][39]41,[70][71][72][73][74][75]…”