High drug resistance levels could compromise the control of HIV infection in paediatric and adolescent population in Kinshasa, the Democratic Republic of Congo.
Background The inadequacy of HIV viraemia and resistance monitoring in Africa leads to uncontrolled circulation of HIV strains with drug resistance mutations (DRM), compromising antiretroviral therapy (ART) effectiveness. This study describes the DRM prevalence and its therapeutic impact in HIV-infe...
| Main Authors: | , , , , , , , |
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| Format: | info:eu-repo/semantics/article |
| Language: | English |
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2022
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| Online Access: | https://hdl.handle.net/10171/62957 |
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| author | Rubio-Garrido, M. (Marina) Reina, G. (Gabriel) Ndarabu, A. (Adolphe) Rodríguez-Galet, A. (Ana) Valadés-Alcaraz, A. (Ana) Barquín, D. (David) Carlos-Chillerón, S. (Silvia) Holguín, Á. (África) |
| author_facet | Rubio-Garrido, M. (Marina) Reina, G. (Gabriel) Ndarabu, A. (Adolphe) Rodríguez-Galet, A. (Ana) Valadés-Alcaraz, A. (Ana) Barquín, D. (David) Carlos-Chillerón, S. (Silvia) Holguín, Á. (África) |
| author_sort | Rubio-Garrido, M. (Marina) |
| collection | DSpace |
| description | Background The inadequacy of HIV viraemia and resistance monitoring in Africa leads to uncontrolled circulation of HIV strains with drug resistance mutations (DRM), compromising antiretroviral therapy (ART) effectiveness. This study describes the DRM prevalence and its therapeutic impact in HIV-infected pediatric patients from Kinshasa (Democratic Republic of Congo, DRC). Methods From 2016-2018, dried blood were collected from 71 HIV-infected children and adolescents under ART in two hospitals in Kinshasa for HIV-1 DRM pol analysis, predicted ARV-susceptibility by Stanford and phylogenetic characterization. Results HIV-1 sequences were recovered from 55 children/adolescents with 14 years of median-age. All had received nucleoside and non-nucleoside reverse transcriptase inhibitors (NRTI, NNRTI), 9.1% protease inhibitors (PI) and only one integrase inhibitor (INI). Despite the use of ART, 89.1% showed virological failure and 67.3% carried viruses with major-DRM to one (12.7%), two (47.3%), or three (5.5%) ARV-families. Most children/adolescents harbored DRM to NNRTI (73.5%) or NRTI (61.2%). Major-DRM to PI was present in 8.3% and minor-DRM to INI in 15%. Dual-class-NRTI+NNRTI resistance appeared in 53.1% of patients. Viruses presented high/intermediate resistance to nevirapine (72.9% patients), efavirenz (70.9%), emtricitabine/lamivudine (47.9%), rilpivirine (41.7%), etravirine (39.6%), doravidine (33.3%), zidovudine (22.9%), among others. Most participants were susceptible to INI and PI. Great diversity of variants was found, with a high rate (40%) of unique recombinants. Conclusion The high DRM prevalence observed among HIV-infected children and adolescents in Kinshasa could compromise the 95-95-95-UNAIDS targets in the DRC. It also reinforces the need for routine resistance monitoring for optimal rescue therapy election in this vulnerable population to control the spread of resistant HIV in the country. |
| format | info:eu-repo/semantics/article |
| id | oai:dadun.unav.edu:10171-62957 |
| institution | Universidad de Navarra |
| language | English |
| publishDate | 2022 |
| record_format | dspace |
| spelling | oai:dadun.unav.edu:10171-629572024-02-09T07:22:49Z High drug resistance levels could compromise the control of HIV infection in paediatric and adolescent population in Kinshasa, the Democratic Republic of Congo. Rubio-Garrido, M. (Marina) Reina, G. (Gabriel) Ndarabu, A. (Adolphe) Rodríguez-Galet, A. (Ana) Valadés-Alcaraz, A. (Ana) Barquín, D. (David) Carlos-Chillerón, S. (Silvia) Holguín, Á. (África) HIV Democratic Republic of the Congo Child Adolescent Background The inadequacy of HIV viraemia and resistance monitoring in Africa leads to uncontrolled circulation of HIV strains with drug resistance mutations (DRM), compromising antiretroviral therapy (ART) effectiveness. This study describes the DRM prevalence and its therapeutic impact in HIV-infected pediatric patients from Kinshasa (Democratic Republic of Congo, DRC). Methods From 2016-2018, dried blood were collected from 71 HIV-infected children and adolescents under ART in two hospitals in Kinshasa for HIV-1 DRM pol analysis, predicted ARV-susceptibility by Stanford and phylogenetic characterization. Results HIV-1 sequences were recovered from 55 children/adolescents with 14 years of median-age. All had received nucleoside and non-nucleoside reverse transcriptase inhibitors (NRTI, NNRTI), 9.1% protease inhibitors (PI) and only one integrase inhibitor (INI). Despite the use of ART, 89.1% showed virological failure and 67.3% carried viruses with major-DRM to one (12.7%), two (47.3%), or three (5.5%) ARV-families. Most children/adolescents harbored DRM to NNRTI (73.5%) or NRTI (61.2%). Major-DRM to PI was present in 8.3% and minor-DRM to INI in 15%. Dual-class-NRTI+NNRTI resistance appeared in 53.1% of patients. Viruses presented high/intermediate resistance to nevirapine (72.9% patients), efavirenz (70.9%), emtricitabine/lamivudine (47.9%), rilpivirine (41.7%), etravirine (39.6%), doravidine (33.3%), zidovudine (22.9%), among others. Most participants were susceptible to INI and PI. Great diversity of variants was found, with a high rate (40%) of unique recombinants. Conclusion The high DRM prevalence observed among HIV-infected children and adolescents in Kinshasa could compromise the 95-95-95-UNAIDS targets in the DRC. It also reinforces the need for routine resistance monitoring for optimal rescue therapy election in this vulnerable population to control the spread of resistant HIV in the country. 2022-02-24T14:28:53Z 2022-02-24T14:28:53Z 2021 info:eu-repo/semantics/article https://hdl.handle.net/10171/62957 en info:eu-repo/semantics/openAccess application/pdf |
| spellingShingle | HIV Democratic Republic of the Congo Child Adolescent Rubio-Garrido, M. (Marina) Reina, G. (Gabriel) Ndarabu, A. (Adolphe) Rodríguez-Galet, A. (Ana) Valadés-Alcaraz, A. (Ana) Barquín, D. (David) Carlos-Chillerón, S. (Silvia) Holguín, Á. (África) High drug resistance levels could compromise the control of HIV infection in paediatric and adolescent population in Kinshasa, the Democratic Republic of Congo. |
| title | High drug resistance levels could compromise the control of HIV infection in paediatric and adolescent population in Kinshasa, the Democratic Republic of Congo. |
| title_full | High drug resistance levels could compromise the control of HIV infection in paediatric and adolescent population in Kinshasa, the Democratic Republic of Congo. |
| title_fullStr | High drug resistance levels could compromise the control of HIV infection in paediatric and adolescent population in Kinshasa, the Democratic Republic of Congo. |
| title_full_unstemmed | High drug resistance levels could compromise the control of HIV infection in paediatric and adolescent population in Kinshasa, the Democratic Republic of Congo. |
| title_short | High drug resistance levels could compromise the control of HIV infection in paediatric and adolescent population in Kinshasa, the Democratic Republic of Congo. |
| title_sort | high drug resistance levels could compromise the control of hiv infection in paediatric and adolescent population in kinshasa, the democratic republic of congo. |
| topic | HIV Democratic Republic of the Congo Child Adolescent |
| url | https://hdl.handle.net/10171/62957 |
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