Details:

Alternative Title:
PLoS One
Publisher's site:
http://dx.doi.org/10.1371/journal.pone.0068213
Personal Author:
Bila, Dulce Celina Adolfo ; Young, Peter ; Merks, Harriet ; Vubil, Adolfo Salvador ; Mahomed, Mussagy ; ... More +
Bila, Dulce Celina Adolfo ; Young, Peter ; Merks, Harriet ; Vubil, Adolfo Salvador ; Mahomed, Mussagy ; Augusto, Angelo ; Abreu, Celina Monteiro ; Mabunda, Nédio Jonas ; Brooks, James I. ; Tanuri, Amilcar ; Jani, Ilesh Vinodrai Less -
Description:
Objective

In Mozambique, highly active antiretroviral treatment (HAART) was introduced in 2004 followed by decentralization and expansion, resulting in a more than 20-fold increase in coverage by 2009. Implementation of HIV drug resistance threshold surveys (HIVDR-TS) is crucial in order to monitor the emergence of transmitted viral resistance, and to produce evidence-based recommendations to support antiretroviral (ARV) policy in Mozambique.

Methods

World Health Organization (WHO) methodology was used to evaluate transmitted drug resistance (TDR) in newly diagnosed HIV-1 infected pregnant women attending ante-natal clinics in Maputo and Beira to non-nucleoside reverse transcriptase inhibitors (NNRTI), nucleoside reverse transcriptase inhibitors (NRTI) and protease inhibitors (PI). Subtypes were assigned using REGA HIV-1 subtyping tool and phylogenetic trees constructed using MEGA version 5.

Results

Although mutations associated with resistance to all three drug were detected in these surveys, transmitted resistance was analyzed and classified as <5% in Maputo in both surveys for all three drug classes. Transmitted resistance to NNRTI in Beira in 2009 was classified between 5–15%, an increase from 2007 when no NNRTI mutations were found. All sequences clustered with subtype C.

Conclusions

Our results show that the epidemic is dominated by subtype C, where the first-line option based on two NRTI and one NNRTI is still effective for treatment of HIV infection, but intermediate levels of TDR found in Beira reinforce the need for constant evaluation with continuing treatment expansion in Mozambique.


Subject:
[+]
Adolescent
Adult
Anti-HIV Agents
Antiretroviral Therapy, Highly Active
Drug Resistance, Viral
Female
Genotype
HIV-1
HIV Infections
Humans
Male
Mutation
Phylogeny
Pregnancy
Young Adult

Source:
PLoS One. 2013; 8(7).
Series:
PEPFAR
Pubmed ID:
23935858
Pubmed Central ID:
PMC3728366
Document Type:
Journal Article
Funding:
1U2GPS001093/PHS HHS/United States ; PEPFAR/United States
1U2GPS001093/PHS HHS/United States ; PEPFAR/United States Less -
Place as Subject:
Mozambique
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:e33fe6a354dc67363fb46ce789ba5667d46ec8c3e19381f0df351c552af098ab
File Type:

Supporting Files

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