Salou M., Butel Christelle, Konou A. A., Ekouevi D. K., Vidal Nicole, Dossim S., Lawson-Evi K., Nyasenu Y. T., Singo-Tokofai A., d'Almeida S., Tchama R., Delaporte Eric, Prince-David M., Peeters Martine, Dagnra A. Y. (2016). High rates of drug resistance among newly diagnosed hiv-infected children in the national prevention of mother-to-child transmission program in Togo. Pediatric Infectious Disease Journal, 35 (8), p. 879-885. ISSN 0891-3668.
Titre du document
High rates of drug resistance among newly diagnosed hiv-infected children in the national prevention of mother-to-child transmission program in Togo
Année de publication
2016
Auteurs
Salou M., Butel Christelle, Konou A. A., Ekouevi D. K., Vidal Nicole, Dossim S., Lawson-Evi K., Nyasenu Y. T., Singo-Tokofai A., d'Almeida S., Tchama R., Delaporte Eric, Prince-David M., Peeters Martine, Dagnra A. Y.
Source
Pediatric Infectious Disease Journal, 2016,
35 (8), p. 879-885 ISSN 0891-3668
Background: Prevention of mother-to-child transmission (PMTCT) programs have been largely scaled-up, but data on infant HIV drug resistance from PMTCT programs implemented in resource-limited countries are lacking. Methods: Remnant dried blood spots from HIV-infected children (aged <18 months) tested through the Togo national early infant diagnosis program during 2012 and 2013 were collected and assessed for HIV drug resistance. Pol-RT (reverse transcriptase) region was amplified, sequenced and analyzed for the presence of drug resistance mutations (DRMs). Results: Overall, 121 of 201 (60.2%) newly diagnosed children had detectable DRMs. Among the 131 of 201 (65.2%) children with reported exposure to maternal and/or infant antiretrovirals (ARVs), DRMs were detected in 99 children (75.6%). Importantly, in 41 of 201 children for whom no exposure to ARVs was reported, DRMs were detected in 11 children (26.8%). For 29 children, no data on ARV exposure were available. For the 121 of 201 children with DRMs, 99 of 121 (81.8%) had only nonnucleoside reverse transcriptase inhibitor DRMs detected but 21 of 121 (17.3%) had both nonnucleoside reverse transcriptase inhibitor and nucleoside reverse transcriptase inhibitor (NRTI) DRMs. Among breast-fed children, drug resistance was more frequent when mothers were on antiretroviral therapy (ART), 61 of 75 (81.3%) versus 14 of 39 (35.9%) when mothers were not on ART (P < 0.001). Nucleoside reverse transcriptase inhibitor resistance was more common when mothers were on ART. Conclusions: Scale-up and improvement of PMTCT strategies resulted in a global decrease of pediatric HIV infections, but our study shows high rates of drug resistance in infants for whom prevention failed.
Plan de classement
Santé : généralités [050]
;
Entomologie médicale / Parasitologie / Virologie [052]
Description Géographique
TOGO
Localisation
Fonds IRD [F B010067754]
Identifiant IRD
fdi:010067754
