Details:

Alternative Title:
Pediatr Infect Dis J
Personal Author:
Louis, Frantz Jean ; Segaren, Nathanael ; Desinor, Olbeg ; Beard, R. Suzanne ; Jean-Louis, Reginald ; ... More +
Louis, Frantz Jean ; Segaren, Nathanael ; Desinor, Olbeg ; Beard, R. Suzanne ; Jean-Louis, Reginald ; Chang, Joy ; Boisson, Sylvie ; Hulland, Erin N. ; Wagar, Nick ; DeVos, Joshua ; François, Kesner ; Buteau, Josiane ; Boncy, Jacques ; Marston, Barbara J. ; Domerçant, Jean Wysler ; Yang, Chunfu ; Charles, Macarthur Less -
Description:
Background:

The main objective of this study was to determine the frequency and patterns of HIVDR-associated mutations among children <18 months old born to HIV-1-positive mothers enrolled in the prevention of mother-to-child transmission (PMTCT) services in Haiti.

Methods:

Between January 1, 2013 and December 31, 2014, HIV-positive remnant dried blood spots (DBS) collected from children under 18 months old for Early Infant Diagnosis (EID) at the National Public Health Laboratory were used for HIV-1 genotyping. HIVDR mutations were analyzed using the Stanford Drug Resistance HIVdb program.

Results:

Of the 3,555 DBS collected for EID, 360 (10.1%) were HIV-positive and 355 were available for genotyping. Of these, 304 (85.6%) were successfully genotyped and 217 (71.4%) had ≥ one DR mutation. Mutations conferring resistance to NRTIs and NNRTIs were present in 40.5% (123) and 69.1% (210), respectively. The most frequent mutations were K103N/S (48.0%), M184V (37.5%), and G190A/S (15.1%), and Y181C/G/V (14.1%). Predicted drug resistance analysis revealed that 68.8% of the children had high-level resistance to NNRTIs and 11.5% had intermediate to high-level resistance to abacavir.

Conclusions:

This study showed high rates of resistance to NRTIs and NNRTIs among newly HIV-diagnosed children in Haiti, suggesting that in the era of “option B+” (initiation of lifelong combination antiretroviral therapy to pregnant women with HIV), the majority of children who acquire HIV infection through MTCT have resistant HIV. These results have led the National HIV Program to revise the pediatric guidelines to include protease inhibitors in first-line regimens for all HIV-positive newborns.


Subject:
[+]
Drug Resistance, Viral
Female
Genotype
Genotyping Techniques
HIV-1
HIV Infections
Humans
Infant
Infant, Newborn
Infectious Disease Transmission, Vertical
Male
Mutation, Missense
Pregnancy
Prevalence

Source:
Pediatr Infect Dis J. 38(5):503-507
Pubmed ID:
30640198
Pubmed Central ID:
PMC6785839
Document Type:
Journal Article
Funding:
CC999999/ImCDC/Intramural CDC HHS/United States ; PEPFAR/PEPFAR/United States
CC999999/ImCDC/Intramural CDC HHS/United States ; PEPFAR/PEPFAR/United States Less -
Place as Subject:
Haiti
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:8a0d93dd7f040079c832589db03c0f273d5d6dfbd4b9d65d52644e91e57f8f4f
File Type:

Supporting Files

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