# name
HIV drug resistance patterns in pregnant women using next
                generation sequence in Mozambique

# metadata.dc.description.abstract[].value
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.

# metadata.dc.relation.isformatof[].value
Reproducció del document publicat a:
                http://dx.doi.org/10.1371/journal.pone.0196451

# metadata.dc.source[].value
Articles publicats en revistes (ISGlobal)

# metadata.dc.title[].value
HIV drug resistance patterns in pregnant women using next
                generation sequence in Mozambique