%0 Journal Article
%9 ACL : Articles dans des revues avec comité de lecture répertoriées par l'AERES
%A Salou, M.
%A Butel, Christelle
%A Konou, A. A.
%A Ekouevi, D. K.
%A Vidal, Nicole
%A Dossim, S.
%A Lawson-Evi, K.
%A Nyasenu, Y. T.
%A Singo-Tokofai, A.
%A d'Almeida, S.
%A Tchama, R.
%A Delaporte, Eric
%A Prince-David, M.
%A Peeters, Martine
%A Dagnra, A. Y.
%T High rates of drug resistance among newly diagnosed hiv-infected children in the national prevention of mother-to-child transmission program in Togo
%D 2016
%L fdi:010067754
%G ENG
%J Pediatric Infectious Disease Journal
%@ 0891-3668
%K newly diagnosed infants ; HIV ; drug resistance ; prevention of mother-to-child transmission ; Africa
%K TOGO
%M ISI:000380755000016
%N 8
%P 879-885
%R 10.1097/inf.0000000000001203
%U https://www.documentation.ird.fr/hor/fdi:010067754
%> https://www.documentation.ird.fr/intranet/publi/2016/09/010067754.pdf
%V 35
%W Horizon (IRD)
%X 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.
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