2026-04-14T04:04:30Zhttps://recercat.cat/oai/request

oai:recercat.cat:2445/1227792025-12-05T00:45:34Zcom_2072_1057col_2072_478917

HIV drug resistance patterns in pregnant women using next generation sequence in Mozambique Rupérez, María Noguera Julian, Marc González, Raquel Maculuve, Sónia Amós Bellido, Rocío Vala, Anifa Rodríguez, Cristina Sevene, Esperança Júlia Pires Paredes, Roger Menéndez, Clara VIH (Virus) Embarassades Moçambic HIV (Viruses) Pregnant women Mozambique BACKGROUND: Few data on HIV resistance in pregnancy are available from Mozambique, one of the countries with the highest HIV toll worldwide. Understanding the patterns of HIV drug resistance in pregnant women might help in tailoring optimal regimens for prevention of mother to child transmission of HIV (pMTCT) and antenatal care. OBJECTIVES: To describe the frequency and characteristics of HIV drug resistance mutations (HIVDRM) in pregnant women with virological failure at delivery, despite pMTCT or antiretroviral therapy (ART). METHODS: Samples from HIV-infected pregnant women from a rural area in southern Mozambique were analysed. Only women with HIV-1 RNA >400c/mL at delivery were included in the analysis. HIVDRM were determined using MiSeq(R) (detection threshold 1%) at the first antenatal care (ANC) visit and at the time of delivery. RESULTS: Ninety and 60 samples were available at the first ANC visit and delivery, respectively. At first ANC, 97% of the women had HIV-1 RNA>400c/mL, 39% had CD4+ counts <350 c/mm3 and 30% were previously not on ART. Thirteen women (14%) had at least one HIVDRM of whom 70% were not on previous ART. Eight women (13%) had at least one HIVDRM at delivery. Out of 37 women with data available from the two time points, 8 (21%) developed at least one new HIVDRM during pMTCT or ART. Twenty seven per cent (53/191), 32% (44/138) and 100% (5/5) of the mutations that were present at enrolment, delivery and that emerged during pregnancy, respectively, were minority mutations (frequency <20%). CONCLUSIONS: Even with ultrasensitive HIV-1 genotyping, less than 20% of women with detectable viremia at delivery had HIVDRM before initiating pMTCT or ART. This suggests that factors other than pre-existing resistance, such as lack of adherence or interruptions of the ANC chain, are also relevant to explain lack of virological suppression at the time of delivery in women receiving antiretrovirals drugs during pregnancy. 2018-06-05T07:22:15Z 2018-06-05T07:22:15Z 2018 2018-05-23T17:59:57Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion 1932-6203 https://hdl.handle.net/2445/122779 29742132 eng Reproducció del document publicat a: http://dx.doi.org/10.1371/journal.pone.0196451 PLoS One, 2018, vol. 13, num. 5, p. e0196451 http://dx.doi.org/10.1371/journal.pone.0196451 cc by (c) Rupérez et a, 2018 http://creativecommons.org/licenses/by/3.0/es/ info:eu-repo/semantics/openAccess 15 p. application/pdf Public Library of Science (PLoS) Articles publicats en revistes (ISGlobal)