title: HIV-1 Variants and Drug Resistance in Pregnant Women from Bata (Equatorial Guinea): 2012-2013.
abstract: OBJECTIVE
  This is the first study describing drug resistance mutations (DRM) and HIV-1 variants among infected pregnant women in Equatorial Guinea (GQ), a country with high (6.2%) and increasing HIV prevalence.
  
  
  METHODS
  Dried blood spots (DBS) were collected from November 2012 to December 2013 from 69 HIV-1 infected women participating in a prevention of mother-to-child transmission program in the Hospital Regional of Bata and Primary Health Care Centre María Rafols, Bata, GQ. The transmitted (TDR) or acquired (ADR) antiretroviral drug resistance mutations at partial pol sequence among naive or antiretroviral therapy (ART)-exposed women were defined following WHO or IAS USA 2015 lists, respectively. HIV-1 variants were identified by phylogenetic analyses.
  
  
  RESULTS
  A total of 38 of 69 HIV-1 specimens were successfully amplified and sequenced. Thirty (79%) belonged to ART-experienced women: 15 exposed to nucleoside reverse transcriptase inhibitors (NRTI) monotherapy, and 15 to combined ART (cART) as first regimen including two NRTI and one non-NRTI (NNRTI) or one protease inhibitor (PI). The TDR rate was only found for PI (3.4%). The ADR rate was 37.5% for NNRTI, 8.7% for NRTI and absent for PI or NRTI+NNRTI. HIV-1 group M non-B variants caused most (97.4%) infections, mainly (78.9%) recombinants: CRF02_AG (55.2%), CRF22_A101 (10.5%), subtype C (10.5%), unique recombinants (5.3%), and A3, D, F2, G, CRF06_cpx and CRF11_cpx (2.6% each).
  
  
  CONCLUSIONS
  The high rate of ADR to retrotranscriptase inhibitors (mainly to NNRTIs) observed among pretreated pregnant women reinforces the importance of systematic DRM monitoring in GQ to reduce HIV-1 resistance transmission and to optimize first and second-line ART regimens when DRM are present.
authors: HIV-1 Molecular Epidemiology Laboratory, Microbiology and Parasitology Department, Hospital Universitario Ramón y Cajal, IRYCIS and CIBERESP, Madrid, Spain.
authors: Patricia
authors: P
authors: Alvarez
authors: Pediatrics Department, Hospital Universitario Gregorio Marañón, Madrid, Spain.
authors: Carolina
authors: C
authors: Fernández McPhee
authors: Pediatrics Department, Hospital Universitario de Getafe, Madrid, Spain.
authors: Luis
authors: L
authors: Prieto
authors: HIV-1 Molecular Epidemiology Laboratory, Microbiology and Parasitology Department, Hospital Universitario Ramón y Cajal, IRYCIS and CIBERESP, Madrid, Spain.
authors: Leticia
authors: L
authors: Martín
authors: Pediatrics Department, Hospital Regional de Bata, Ministerio de Sanidad y Bienestar Social, Bata, Equatorial Guinea.
authors: Jacinta
authors: J
authors: Obiang
authors: Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III-Madrid, RICET, Madrid, Spain.
authors: Pedro
authors: P
authors: Avedillo
authors: Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III-Madrid, RICET, Madrid, Spain.
authors: Antonio
authors: A
authors: Vargas
authors: Pediatrics Department, Hospital Universitario Doce de Octubre, Madrid, Spain.
authors: Pablo
authors: P
authors: Rojo
authors: Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III-Madrid, RICET, Madrid, Spain.
authors: Agustín
authors: A
authors: Benito
authors: Pediatrics Department, Hospital Universitario Clínico San Carlos, Madrid, Spain.
authors: José Tomás
authors: JT
authors: Ramos
authors: HIV-1 Molecular Epidemiology Laboratory, Microbiology and Parasitology Department, Hospital Universitario Ramón y Cajal, IRYCIS and CIBERESP, Madrid, Spain.
authors: África
authors: Á
authors: Holguín
mesh_terms: D024882:Drug Resistance, Viral / Q000235:genetics*; D016703:Equatorial Guinea / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000235:genetics / Q000821:virology; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D009154:Mutation / Q000235:genetics*; D011247:Pregnancy; D055815:Young Adult