HIV-1 drug resistance in recently HIV-infected pregnant mother's naïve to antiretroviral therapy in Dodoma urban, Tanzania.
BACKGROUND
HIV resistance affects virological response to therapy and efficacy of prophylaxis in mother-to-child-transmission. The study aims to assess the prevalence of HIV primary resistance in pregnant women naïve to antiretrovirals.


METHODS
Cross sectional baseline analysis of a cohort of HIV + pregnant women (HPW) enrolled in the study entitled Antiretroviral Management of Antenatal and Natal HIV Infection (AMANI, peace in Kiswahili language). The AMANI study began in May 2010 in Dodoma, Tanzania. In this observational cohort, antiretroviral treatment was provided to all women from the 28th week of gestation until the end of the breastfeeding period. Baseline CD4 cell count, viral load and HIV drug-resistance genotype were collected.


RESULTS
Drug-resistance analysis was performed on 97 naïve infected-mothers. The prevalence of all primary drug resistance and primary non-nucleoside reverse-transcriptase inhibitors resistance was 11.9% and 7.5%, respectively. K103S was found in two women with no M184V detection. HIV-1 subtype A was the most commonly identified, with a high prevalence of subtype A1, followed by C, D, C/D recombinant, A/C recombinant and A/D recombinant. HIV drug- resistance mutations were detected in A1 and C subtypes.


CONCLUSIONS
Our study reports an 11.9% prevalence rate of primary drug resistance in naïve HIV-infected pregnant women from a remote area of Tanzania. Considering that the non-nucleoside reverse-transcriptase inhibitors are part of the first-line antiretroviral regimen in Tanzania and all of Africa, resistance surveys should be prioritized in settings where antiretroviral therapy programs are scaled up.
"L, Spallanzani" National Institute for Infectious Diseases- INMI, Via Portuense 292, 00149 Rome, Italy. francvairo@gmail.com.
Francesco
F
Vairo
Emanuele
E
Nicastri
Giuseppina
G
Liuzzi
Zainab
Z
Chaula
Boniface
B
Nguhuni
Nazario
N
Bevilacqua
Federica
F
Forbici
Alessandra
A
Amendola
Lavinia
L
Fabeni
Pasquale
P
De Nardo
Carlo Federico
CF
Perno
Angela
A
Cannas
Calistus
C
Sakhoo
Maria Rosaria
MR
Capobianchi
Giuseppe
G
Ippolito
D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000635:transmission / Q000821:virology*; D015497:HIV-1 / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008969:Molecular Sequence Data; D009035:Mothers; D010802:Phylogeny; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy* / Q000821:virology; D013636:Tanzania / Q000453:epidemiology; D014504:Urban Health; D055815:Young Adult
D019380:Anti-HIV Agents