Please use this identifier to cite or link to this item:
Title: HIV drug resistance patterns in pregnant women using next generation sequence in Mozambique
Author: Rupérez, María
Noguera Julian, Marc
González, Raquel
Maculuve, Sónia Amós
Bellido, Rocío
Vala, Anifa
Rodríguez, Cristina
Sevene, Esperança Júlia Pires
Paredes, Roger
Menéndez, Clara
Keywords: VIH (Virus)
HIV (Viruses)
Pregnant women
Issue Date: 2018
Publisher: Public Library of Science (PLoS)
Abstract: BACKGROUND: Few data on HIV resistance in pregnancy are available from Mozambique, one of the countries with the highest HIV toll worldwide. Understanding the patterns of HIV drug resistance in pregnant women might help in tailoring optimal regimens for prevention of mother to child transmission of HIV (pMTCT) and antenatal care. OBJECTIVES: To describe the frequency and characteristics of HIV drug resistance mutations (HIVDRM) in pregnant women with virological failure at delivery, despite pMTCT or antiretroviral therapy (ART). METHODS: Samples from HIV-infected pregnant women from a rural area in southern Mozambique were analysed. Only women with HIV-1 RNA >400c/mL at delivery were included in the analysis. HIVDRM were determined using MiSeq(R) (detection threshold 1%) at the first antenatal care (ANC) visit and at the time of delivery. RESULTS: Ninety and 60 samples were available at the first ANC visit and delivery, respectively. At first ANC, 97% of the women had HIV-1 RNA>400c/mL, 39% had CD4+ counts <350 c/mm3 and 30% were previously not on ART. Thirteen women (14%) had at least one HIVDRM of whom 70% were not on previous ART. Eight women (13%) had at least one HIVDRM at delivery. Out of 37 women with data available from the two time points, 8 (21%) developed at least one new HIVDRM during pMTCT or ART. Twenty seven per cent (53/191), 32% (44/138) and 100% (5/5) of the mutations that were present at enrolment, delivery and that emerged during pregnancy, respectively, were minority mutations (frequency <20%). CONCLUSIONS: Even with ultrasensitive HIV-1 genotyping, less than 20% of women with detectable viremia at delivery had HIVDRM before initiating pMTCT or ART. This suggests that factors other than pre-existing resistance, such as lack of adherence or interruptions of the ANC chain, are also relevant to explain lack of virological suppression at the time of delivery in women receiving antiretrovirals drugs during pregnancy.
Note: Reproducció del document publicat a:
It is part of: PLoS One, 2018, vol. 13, num. 5, p. e0196451
Related resource:
ISSN: 1932-6203
Appears in Collections:Articles publicats en revistes (ISGlobal)

Files in This Item:
File Description SizeFormat 
ruperez2018_3043.pdf676.53 kBAdobe PDFView/Open

This item is licensed under a Creative Commons License Creative Commons