title: Short communication: Transmitted HIV drug resistance in antiretroviral-naive pregnant women in north central Nigeria.
abstract: The World Health Organization (WHO) recommends periodic surveillance of transmitted drug resistance (TDR) in communities in which antiretroviral therapy (ART) has been scaled-up for greater than 3 years. We conducted a survey of TDR mutations among newly detected HIV-infected antiretroviral (ARV)-naive pregnant women. From May 2010 to March 2012, 38 ARV-naive pregnant women were recruited in three hospitals in Jos, Plateau state, north central Nigeria. Eligible subjects were recruited using a modified version of the binomial sequential sampling technique recommended by WHO. HIV-1 genotyping was performed and HIV-1 drug resistance mutations were characterized according to the WHO 2009 surveillance drug resistance mutation (SDRM) list. HIV subtypes were determined by phylogenetic analysis. The women's median age was 25.5 years; the median CD4(+) cell count was 317 cells/μl and the median viral load of 16 was 261 copies/ml. Of the 38 samples tested, 34 (89%) were successfully genotyped. The SDRM rate was <5% for all ART drug classes, with 1/34 (2.9%) for NRTIs/NNRTIs and none for protease inhibitors 0/31 (0%). The specific SDRMs detected were M41L for nucleoside reverse transcriptase inhibitors (NRTIs) and G190A for nonnucleoside reverse transcriptase inhibitors (NNRTIs). HIV-1 subtypes detected were CRF02_AG (38.2%), G' (41.2%), G (14.7%), CRF06-CPX (2.9%), and a unique AG recombinant form (2.9%). The single ARV-native pregnant woman with SDRMs was infected with HIV-1 subtype G'. Access to ART has been available in the Jos area for over 8 years. The prevalence of TDR lower than 5% suggests proper ART administration, although continued surveillance is warranted.
authors.affiliation: 1 Jos University Teaching Hospital (JUTH) , APIN Centre, Jos, Nigeria .
authors.forename: Godwin E
authors.initials: GE
authors.lastname: Imade
authors.forename: Atiene S
authors.initials: AS
authors.lastname: Sagay
authors.forename: Beth
authors.initials: B
authors.lastname: Chaplin
authors.forename: Philippe
authors.initials: P
authors.lastname: Chebu
authors.forename: Jonah
authors.initials: J
authors.lastname: Musa
authors.forename: Jonathan
authors.initials: J
authors.lastname: Okpokwu
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Hamel
authors.forename: Ishaya C
authors.initials: IC
authors.lastname: Pam
authors.forename: Oche
authors.initials: O
authors.lastname: Agbaji
authors.forename: Jay
authors.initials: J
authors.lastname: Samuels
authors.forename: Seema
authors.initials: S
authors.lastname: Meloni
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Sankale
authors.forename: Prosper
authors.initials: P
authors.lastname: Okonkwo
authors.forename: Phyllis
authors.initials: P
authors.lastname: Kanki
mesh_terms: D000328:Adult; D016000:Cluster Analysis; D024882:Drug Resistance, Viral; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission* / Q000821:virology; D015497:HIV-1 / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008969:Molecular Sequence Data; D009549:Nigeria / Q000453:epidemiology; D010802:Phylogeny; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology* / Q000821:virology; D012367:RNA, Viral / Q000235:genetics; D017422:Sequence Analysis, DNA; D055815:Young Adult
chemical_list: D012367:RNA, Viral