High Levels of HIV-1 Drug Resistance in Children Who Acquired HIV Infection Through Mother to Child Transmission in the Era of Option B+, Haiti, 2013 to 2014
| Autor: | Frantz Jean Louis, Joshua DeVos, Sylvie Boisson, Josiane Buteau, Erin Hulland, Nathanael Segaren, Jean Wysler Domercant, Kesner François, Jacques Boncy, Barbara J. Marston, Nick Wagar, R. Suzanne Beard, Macarthur Charles, Reginald Jean-Louis, Chunfu Yang, Olbeg Désinor, Joy Chang |
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| Rok vydání: | 2019 |
| Předmět: |
Male
Microbiology (medical) Pediatrics medicine.medical_specialty Mother to child transmission Genotype Genotyping Techniques Mutation Missense Human immunodeficiency virus (HIV) HIV Infections Drug resistance medicine.disease_cause Article 03 medical and health sciences 0302 clinical medicine Pregnancy 030225 pediatrics Drug Resistance Viral Prevalence Humans Medicine 030212 general & internal medicine Infectious disease transmission business.industry Transmission (medicine) Infant Newborn Recem nascido Infant virus diseases medicine.disease Haiti Infectious Disease Transmission Vertical Infectious Diseases Pediatrics Perinatology and Child Health HIV-1 Female business |
| Zdroj: | Pediatr Infect Dis J |
| ISSN: | 0891-3668 |
| Popis: | The main objective of this study was to determine the frequency and patterns of HIV drug resistance-associated mutations among children under 18 months of age born to HIV-1-positive mothers enrolled in the prevention of mother-to-child transmission services in Haiti.Between January 1, 2013 and December 31, 2014, HIV-positive remnant dried blood spots collected from children under 18 months of age for Early Infant Diagnosis at the National Public Health Laboratory were used for HIV-1 genotyping. HIV drug resistance mutations were analyzed using the Stanford Drug Resistance HIVdb program.Of the 3555 dried blood spots collected for Early Infant Diagnosis, 360 (10.1%) were HIV-positive and 355 were available for genotyping. Of these, 304 (85.6%) were successfully genotyped and 217 (71.4%) had ≥1 drug resistance mutation. Mutations conferring resistance to nucleoside reverse transcriptase inhibitor (NRTIs) and non-NRTIs were present in 40.5% (123) and 69.1% (210), respectively. The most frequent mutations were K103N/S (48.0%), M184V (37.5%), G190A/S (15.1%), and Y181C/G/V (14.1%). Predicted drug resistance analysis revealed that 68.8% of the children had high-level resistance to non-NRTIs and 11.5% had intermediate to high-level resistance to abacavir.This study showed high rates of resistance to NRTIs and non-NRTIs among newly HIV-diagnosed children in Haiti, suggesting that in the era of "Option B+" (initiation of lifelong combination antiretroviral therapy to pregnant women with HIV), the majority of children who acquire HIV infection through mother-to-child transmission of HIV have resistant HIV. These results have led the National HIV Program to revise the pediatric guidelines to include protease inhibitors in first-line regimens for all HIV-positive newborns. |
| Databáze: | OpenAIRE |
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