title: Frequent detection of antiretroviral drug resistance in HIV-1-infected orphaned children followed at a donor-funded rural pediatric clinic in Dodoma, Tanzania.
abstract: A total of 81 HIV-1 protease (PR) and reverse transcriptase (RT) sequences were obtained from 46 drug-naive and 35 pretreated individual HIV-1-infected orphaned children followed at a donor-funded rural pediatric clinic in Dodoma, Tanzania. PR and RT sequencing was performed by home-brew technology on 70 plasma samples and 11 dried blood spot specimens. Nucleoside RT inhibitor (NRTI) resistance mutations were detected in 2.2% of drug-naive and 82.9% of pretreated children. Nonnucleoside RT inhibitor (NNRTI) resistance mutations were detected in 69.6% of drug-naive and 91.4% of pretreated children. Resistance to protease inhibitors was rare (8.6% in pretreated children). Based on few complete treatment records, only around 20% of the treated children had undetectable plasma HIV-1 RNA. The rate of NRTI and NNRTI resistance in this donor-funded rural pediatric clinic was high and appeared to limit virological response to treatment.
authors.affiliation: 1 Department of Medical Biotechnologies, University of Siena , Siena, Italy .
authors.forename: Genny
authors.initials: G
authors.lastname: Meini
authors.forename: Maddalena
authors.initials: M
authors.lastname: Balestrieri
authors.forename: Sergio
authors.initials: S
authors.lastname: Cianchino
authors.forename: Danilo
authors.initials: D
authors.lastname: Tacconi
authors.forename: Marco
authors.initials: M
authors.lastname: Rossi de Gasperis
authors.forename: Carlo
authors.initials: C
authors.lastname: Concato
authors.forename: Ilaria
authors.initials: I
authors.lastname: Vicenti
authors.forename: Andrea
authors.initials: A
authors.lastname: Rosi
authors.forename: Francesco
authors.initials: F
authors.lastname: Saladini
authors.forename: Francesco
authors.initials: F
authors.lastname: Callea
authors.forename: Maurizio
authors.initials: M
authors.lastname: Zazzi
mesh_terms: D044966:Anti-Retroviral Agents / Q000494:pharmacology*; D002648:Child; D054540:Child, Orphaned; D024882:Drug Resistance, Viral; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000821:virology*; D016333:HIV Protease / Q000235:genetics; D054303:HIV Reverse Transcriptase / Q000235:genetics; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D020125:Mutation, Missense; D012424:Rural Population; D017422:Sequence Analysis, DNA; D013636:Tanzania
chemical_list: D044966:Anti-Retroviral Agents; C514824:reverse transcriptase, Human immunodeficiency virus 1; D054303:HIV Reverse Transcriptase; D016333:HIV Protease; C514803:p16 protease, Human immunodeficiency virus 1