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Open Access Highly Accessed Research article

HIV-1 drug resistance in recently HIV-infected pregnant mother’s naïve to antiretroviral therapy in Dodoma urban, Tanzania

Francesco Vairo1*, Emanuele Nicastri1, Giuseppina Liuzzi1, Zainab Chaula2, Boniface Nguhuni2, Nazario Bevilacqua1, Federica Forbici1, Alessandra Amendola1, Lavinia Fabeni1, Pasquale De Nardo1, Carlo Federico Perno1, Angela Cannas1, Calistus Sakhoo2, Maria Rosaria Capobianchi1, Giuseppe Ippolito1 and The AMANI Study Group

Author Affiliations

1 “L. Spallanzani” National Institute for Infectious Diseases- INMI, Via Portuense 292, 00149 Rome, Italy

2 Resource Centre for Infectious Diseases, Dodoma Regional Hospital, Dodoma, Tanzania

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BMC Infectious Diseases 2013, 13:439  doi:10.1186/1471-2334-13-439

Published: 21 September 2013

Abstract

Background

HIV resistance affects virological response to therapy and efficacy of prophylaxis in mother-to-child-transmission. The study aims to assess the prevalence of HIV primary resistance in pregnant women naïve to antiretrovirals.

Methods

Cross sectional baseline analysis of a cohort of HIV + pregnant women (HPW) enrolled in the study entitled Antiretroviral Management of Antenatal and Natal HIV Infection (AMANI, peace in Kiswahili language). The AMANI study began in May 2010 in Dodoma, Tanzania. In this observational cohort, antiretroviral treatment was provided to all women from the 28th week of gestation until the end of the breastfeeding period. Baseline CD4 cell count, viral load and HIV drug-resistance genotype were collected.

Results

Drug-resistance analysis was performed on 97 naïve infected-mothers. The prevalence of all primary drug resistance and primary non-nucleoside reverse-transcriptase inhibitors resistance was 11.9% and 7.5%, respectively. K103S was found in two women with no M184V detection. HIV-1 subtype A was the most commonly identified, with a high prevalence of subtype A1, followed by C, D, C/D recombinant, A/C recombinant and A/D recombinant. HIV drug- resistance mutations were detected in A1 and C subtypes.

Conclusion

Our study reports an 11.9% prevalence rate of primary drug resistance in naïve HIV-infected pregnant women from a remote area of Tanzania. Considering that the non-nucleoside reverse-transcriptase inhibitors are part of the first-line antiretroviral regimen in Tanzania and all of Africa, resistance surveys should be prioritized in settings where antiretroviral therapy programs are scaled up.

Keywords:
HIV-drug resistance; MTCT; HIV-genotype; Low-resources countries