Factors Influencing HIV Drug Resistance among Pregnant Women in Luanda, Angola: Findings from a Cross-Sectional Study.

Cruz S Sebastião,Miguel Brito,Joana Morais

doi:10.3390/tropicalmed6010029

Cruz S Sebastião, Miguel Brito + Show 1 more

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https://doi.org/10.3390/tropicalmed6010029

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Abstract

The increase in HIV infection and drug-resistant strains is an important public health concern, especially in resource-limited settings. However, the identification of factors related to the propagation of infectious diseases represents a crucial target offering an opportunity to reduce health care costs as well as deepening the focus on preventing infection in high-risk groups. In this study, we investigate the factors related to drug resistance among HIV-infected pregnant women in Luanda, the capital city of Angola. This was a part of a cross-sectional study conducted with 42 HIV-positive pregnant women. A blood sample was collected, and HIV-1 genotyping was carried out using an in-house method. Multivariate analyses were performed to determine the interaction between sociodemographic characteristics and drug resistance. HIV drug resistance was detected in 44.1% of the studied population. High probabilities of drug resistance were observed for HIV-infected pregnant women living in rural areas (AOR: 2.73; 95% CI: 0.50–14.9) with high educational level (AOR: 6.27; 95% CI: 0.77–51.2) and comorbidities (AOR: 5.47; 95% CI: 0.28–106) and infected with a HIV-1 non-B subtype other than subtype C (AOR: 1.60; 95% CI: 0.25–10.3). The present study reports high HIV drug resistance. Furthermore, older-age, rural areas, high educational levels, unemployed status, having comorbidities, and HIV-1 subtypes were factors related to drug resistance. These factors impact on drug susceptibility and need to be urgently addressed in order to promote health education campaigns able to prevent the spread of drug-resistant HIV strains in Angola.

Highlights

The human immunodeficiency virus (HIV) remains a global public health problem [1].In 2019, an estimated 37.9 million people were living with HIV worldwide [2]
The antiretroviral drugs currently approved to treat HIV infection belong to distinctive classes that act in different phases of the HIV replication as fusion inhibitor, nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), integrase inhibitors, and protease inhibitors (PIs) [4]
We report a small study with antiretroviral treatment (ART)-naïve pregnant women in terms of the burden of transmitted DRMs, and to investigate factors related to increasing HIV drug resistance (HIVDR)

Summary

Introduction

In 2019, an estimated 37.9 million people were living with HIV worldwide [2]. Around 220,000 of the infected were living in Angola [2]. The antiretroviral drugs currently approved to treat HIV infection belong to distinctive classes that act in different phases of the HIV replication as fusion inhibitor, nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), integrase inhibitors, and protease inhibitors (PIs) [4]. Countless factors, including drug-resistant strains, HIV subtypes, viral load monitoring, treatment adherence, comorbidities, and sociodemographic characteristics, have been associated with the development of drug resistance in HIV-infected pregnant women from low- and middle-income countries (LMICs) [5,6,7,8,9,10]

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