Abstract
BackgroundAntiretrovirals have been available in Ghana since 2003 for HIV-1 positive pregnant women for prevention of mother-to-child transmission (PMTCT). Suboptimal responses to treatment observed post-PMTCT interventions necessitated the need to investigate the profile of viral mutations generated. This study investigated HIV-1 drug resistance profiles in mothers in selected centres in Ghana on treatment with a history of prophylaxis.MethodsGenotypic Drug Resistance Testing for HIV-1 was carried out. Subtyping was done by phylogenetic analysis and Stanford HIV Database programme was used for drug resistance analysis and interpretation. To compare the significance between the different groups and the emergence of drug resistance mutations, p values were used.ResultsParticipants who had prophylaxis before treatment, those who had treatment without prophylaxis and those yet to initiate PMTCT showed 32% (8), 5% (3) and 15% (4) HIV-1 drug resistance associated mutations respectively. The differences were significant with p value < 0.05. Resistance Associated Mutations (RAMs) were seen in 14 participants (35%) to nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs). The most common NRTI mutation found was M184 V; K103 N and A98G were the most common NNRTI mutations seen. Thymidine Analogue Mutations (TAMs) such as M41 L, K70R and T215Y were found in all the groups; the most common of the TAMs found were M41 L and T215Y. Majority of the subtypes were CRF02_AG (82%).ConclusionIn Ghana initiation of uninterrupted treatment upon diagnosis, coupled with drug resistance testing, would produce a better treatment outcome for HIV-1 positive pregnant women.
Highlights
Antiretrovirals have been available in Ghana since 2003 for Human immunodeficiency virus (HIV)-1 positive pregnant women for prevention of mother-to-child transmission (PMTCT)
Characteristics of study participants Out of 116 participants, (21.6%) were mothers who were on Antiretroviral therapy (ART) after previous PMTCT prophylaxis (Group 1Prophylaxis plus ART group), (22.4%) were pregnant HIV-positive drug-naïve participants (Group 2- Drug-Naïve group), and 65 (56.0%) were mothers who had been put directly on ART without prophylaxis as a result of low Cluster of differentiation type 4 (CD4) + T cell count at the time they were pregnant (Group 3Drug-Experienced without Prophylaxis group)
This study has shown that the target of eliminating mother-to-child transmission of HIV-1 in Ghana would be enhanced by giving ART upon diagnosis without prophylaxis
Summary
Antiretrovirals have been available in Ghana since 2003 for HIV-1 positive pregnant women for prevention of mother-to-child transmission (PMTCT). Ghana amongst patients initiating antiretroviral therapy (ART) These two surveys were designed to monitor the impact of HIV-1 drug resistance on the ART programme [4]. A group of patients fall in a grey area not covered directly by the two surveys This group comprised HIV positive women given antiretrovirals as prophylaxis to prevent the transmission of HIV to their babies during pregnancy and subsequently given treatment for their own health post-partum. Bearing in mind the emergence of drug resistance in the face of antiretroviral pressure, these women were given the same ARVs in the treatment phase as they were given during the prophylaxis or the phase of preventing the transmission of the infection from the mother to the infant [2]. The effectiveness of the ARVs with such a background was becoming questionable in the absence of data on the resistance profiles of these women
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
