The case for addressing primary resistance mutations to non-nucleoside reverse transcriptase inhibitors to treat children born from mothers living with HIV in sub-Saharan Africa.
The prevalence of human immunodeficiency virus (HIV) drug resistance mutations (DRMs) was estimated in 25 untreated infants who were living with HIV-1, younger than 13 months and living in Senegal. Antiretroviral DRMs were detected in 8 of 25 (32%) children. Non-nucleoside reverse transcriptase inhibitor (NNRTI) DRMs were present in all (100%) children whose viruses harboured DRMs: K103N in 43%; Y181C, K101E and V106M each in 29%; and Y188L in 14%. The D67N thymidine-analogue mutation was observed in only two children whose mothers had received chemoprophylaxis of mother-to-child transmission (MTCT). The proportion of children whose viruses harboured DRMs was then 6.5-fold higher in children whose mother-child couples had received nevirapine (NVP)-based chemoprophylaxis than in other couples without prophylaxis [7 of 13 (53.8%) vs. 1 of 12 (8.3%)]. These findings point to the absolute need to address primary resistance mutations in case of virological failure in young children treated by antiretroviral drugs, and to make more effective treatment regimens available to NVP-exposed infants living with HIV-1 in Senegal.
Laboratoire de Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Sénégal.
Khady
K
Kébé
Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Laboratoire de Virologie, Paris, France; Faculté de Médecine, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
Laurent
L
Bélec
Laboratoire de Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Sénégal.
Halimatou
H
Diop Ndiaye
Laboratoire de Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Sénégal.
Sokhna
S
Bousso Gueye
Laboratoire de Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Sénégal.
Abou
A
Abdallah Malick Diouara
Laboratoire de Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Sénégal.
Safiétou
S
Ngom
Hôpital d'Enfants Albert Royer de Dakar, Dakar, Senegal.
Ndéye
N
Rama Diagne Gueye
Centre de Santé Roi Baudouin de Dakar and Synergie pour l'enfant, Dakar, Sénégal.
Ngagne
N
Mbaye
Hôpital d'Enfants Albert Royer de Dakar, Dakar, Senegal.
Haby
H
Signaté Sy
Laboratoire de Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Sénégal.
Souleymane
S
Mboup
Laboratoire de Bactériologie-Virologie, CHU Aristide le Dantec, Dakar, Sénégal; ctourekane@yahoo.co.uk.
Coumba
C
Touré Kane
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D024882:Drug Resistance, Viral / Q000235:genetics*; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D009154:Mutation; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D012675:Senegal / Q000453:epidemiology
D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors
HIV antiretroviral drug resistance; Senegal; children; mother-to-child transmission; nevirapine