title: Surveillance of antiretroviral drug resistance mutations in untreated young children living in the Central African Republic.
abstract: BACKGROUND
  A survey of drug resistance-associated mutations (DRMs) was conducted in 2009 among 77 vertically HIV-infected children not treated by antiretroviral drugs, followed up at the Complexe Pédiatrique of Bangui, (Bangui, Central African Republic), a country where HIV mother-to-child transmission is prevented by the wide use of single-dose nevirapine in delivering mother and neonate.
  
  
  METHODS
  Protease and reverse transcriptase sequencing was performed using the ViroSeq HIV-1 genotyping system, and DRMs were identified according to the 2009 update surveillance of transmitted HIV-1 drug resistance.
  
  
  RESULTS
  DRMs were detected in 6 out of 43 samples with interpretable genotypic resistance tests, leading to a 'moderate' DRM prevalence of 13.9% (95% CI 3.5-24.3). DRM to non-nucleoside reverse transcriptase inhibitors were found in 5 samples (11.6% [95% CI, 2.0-21.2]) involving K103N, Y181C and G190A mutations. DRMs to nucleoside reverse transcriptase inhibitors was found in 1 sample (2.3% [95% CI 0.0-6.8]), with the K219Q mutation. No DRMs to protease inhibitors was detected.
  
  
  CONCLUSIONS
  This survey predicts a moderate (between 5% and 15%) prevalence of DRMs in the Central African HIV-infected paediatric population of Bangui. These observations highlight the need to make an early diagnosis of the possibility of virological failure in Central African children receiving their first-line antiretroviral regimen.
authors.affiliation: Laboratoire de Virologie, Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris 5, Paris, France. charlotte.charpentier@bch.aphp.fr
authors.forename: Charlotte
authors.initials: C
authors.lastname: Charpentier
authors.forename: Jean-Chrysostome
authors.initials: JC
authors.lastname: Gody
authors.forename: Pascaline
authors.initials: P
authors.lastname: Tisserand
authors.forename: Mathieu
authors.initials: M
authors.lastname: Matta
authors.forename: Hélène
authors.initials: H
authors.lastname: Péré
authors.forename: Julien
authors.initials: J
authors.lastname: Fournier
authors.forename: Olivia
authors.initials: O
authors.lastname: Mbitikon
authors.forename: Laurent
authors.initials: L
authors.lastname: Bélec
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002488:Central African Republic / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D016172:DNA Fingerprinting; D004252:DNA Mutational Analysis; D024882:Drug Resistance, Viral / Q000235:genetics*; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000635:transmission / Q000821:virology; D016333:HIV Protease / Q000235:genetics*; D054303:HIV Reverse Transcriptase / Q000235:genetics*; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics* / Q000472:pathogenicity; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008297:Male; D009154:Mutation; D019829:Nevirapine / Q000008:administration & dosage / Q000627:therapeutic use*; D011159:Population Surveillance; D015995:Prevalence; D018894:Reverse Transcriptase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D019829:Nevirapine; D054303:HIV Reverse Transcriptase; D016333:HIV Protease