HIV genotypic resistance among pregnant women initiating ART in Uganda: a baseline evaluation of participants in the Option B+ clinical trial.
Journal
African health sciences
ISSN: 1729-0503
Titre abrégé: Afr Health Sci
Pays: Uganda
ID NLM: 101149451
Informations de publication
Date de publication:
Dec 2022
Dec 2022
Historique:
medline:
25
4
2023
pubmed:
24
4
2023
entrez:
24
04
2023
Statut:
ppublish
Résumé
Pre-treatment HIV drug resistance is a threat to elimination of mother to child HIV transmission and could lead to virological failure among HIV-positive pregnant women. We analysed genotypic HIV drug resistance (HIVDR) of baseline samples of participants enrolled in the Option B+ clinical trial in Uganda. HIV-infected pregnant women attending antenatal care were enrolled from Uganda's National Referral Hospital (Mulago) and Mityana District general hospital and surrounding health centers (HCs). Genotypic HIV testing was performed on blood samples from the first 135 enrolled women out of a subset of 136 participants (25%) who had a baseline VL>1000 copies/mL as one sample failed to amplify. 159/540 (29.4%) had a VL < 1000 copies/ml and 381/540 (70.6%) had a VL >1,000 copies/ml. Of the women with VL>1000 copies/ml, 32 (23.7%) had resistance mutations including 29/135 (21.5%) NNRTI mutations, 6/135 (4.4%) NRTI mutations and 3/135 (2.2%) had both NNRTI and NRTI mutations. The most common NNRTI resistance mutations were: K103KN (5), K103N (5), V179T (4) and E138A (4). One quarter of the HIV-infected pregnant women in this trial at baseline had NNRTI genotypic resistance mutations. Our findings support new WHO guidelines for first-line ART that were changed to dolutegravir-based regimens.
Sections du résumé
Background
UNASSIGNED
Pre-treatment HIV drug resistance is a threat to elimination of mother to child HIV transmission and could lead to virological failure among HIV-positive pregnant women. We analysed genotypic HIV drug resistance (HIVDR) of baseline samples of participants enrolled in the Option B+ clinical trial in Uganda.
Methods
UNASSIGNED
HIV-infected pregnant women attending antenatal care were enrolled from Uganda's National Referral Hospital (Mulago) and Mityana District general hospital and surrounding health centers (HCs). Genotypic HIV testing was performed on blood samples from the first 135 enrolled women out of a subset of 136 participants (25%) who had a baseline VL>1000 copies/mL as one sample failed to amplify.
Results
UNASSIGNED
159/540 (29.4%) had a VL < 1000 copies/ml and 381/540 (70.6%) had a VL >1,000 copies/ml. Of the women with VL>1000 copies/ml, 32 (23.7%) had resistance mutations including 29/135 (21.5%) NNRTI mutations, 6/135 (4.4%) NRTI mutations and 3/135 (2.2%) had both NNRTI and NRTI mutations. The most common NNRTI resistance mutations were: K103KN (5), K103N (5), V179T (4) and E138A (4).
Conclusions
UNASSIGNED
One quarter of the HIV-infected pregnant women in this trial at baseline had NNRTI genotypic resistance mutations. Our findings support new WHO guidelines for first-line ART that were changed to dolutegravir-based regimens.
Identifiants
pubmed: 37092059
doi: 10.4314/ahs.v22i4.48
pii: jAFHS.v22.i4.pg428
pmc: PMC10117495
doi:
Substances chimiques
Anti-HIV Agents
0
Types de publication
Clinical Trial
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
428-434Informations de copyright
© 2022 Amone A et al.
Déclaration de conflit d'intérêts
The authors declare that they have no competing interests
Références
AIDS Patient Care STDS. 2018 Jul;32(7):257-264
pubmed: 29985647
J Infect Dis. 2017 Dec 19;216(12):1569-1578
pubmed: 29040633
EClinicalMedicine. 2019 Mar 18;9:26-34
pubmed: 31143879
Lancet. 2012 Oct 6;380(9849):1250-8
pubmed: 22828485
AIDS Res Hum Retroviruses. 2014 Sep;30(9):896-906
pubmed: 24960249
Lancet Infect Dis. 2012 Apr;12(4):307-17
pubmed: 22036233
PLoS One. 2018 Oct 31;13(10):e0206406
pubmed: 30379960
PLoS One. 2017 May 31;12(5):e0178297
pubmed: 28562612
BMC Infect Dis. 2015 Apr 08;15:175
pubmed: 25886277
BMC Infect Dis. 2013 Sep 21;13:439
pubmed: 24053581