High drug Resistance Levels could Compromise the Control of HIV Infection in Paediatric and Adolescent Population in Kinshasa, the Democratic Republic of Congo

Overview

Journal PLoS One

Specialties General Medicine
Science

Date 2021 Apr 15

PMID 33857166

Citations 4

Authors

Marina Rubio-Garrido

Gabriel Reina

Adolphe Ndarabu

Ana Rodriguez-Galet

Ana Valades-Alcaraz

David Barquin

Silvia Carlos

Africa Holguin

Affiliations

Soon will be listed here.

Abstract

Background: The inadequacy of HIV viraemia and resistance monitoring in Africa leads to uncontrolled circulation of HIV strains with drug resistance mutations (DRM), compromising antiretroviral therapy (ART) effectiveness. This study describes the DRM prevalence and its therapeutic impact in HIV-infected pediatric patients from Kinshasa (Democratic Republic of Congo, DRC).

Methods: From 2016-2018, dried blood were collected from 71 HIV-infected children and adolescents under ART in two hospitals in Kinshasa for HIV-1 DRM pol analysis, predicted ARV-susceptibility by Stanford and phylogenetic characterization.

Results: HIV-1 sequences were recovered from 55 children/adolescents with 14 years of median-age. All had received nucleoside and non-nucleoside reverse transcriptase inhibitors (NRTI, NNRTI), 9.1% protease inhibitors (PI) and only one integrase inhibitor (INI). Despite the use of ART, 89.1% showed virological failure and 67.3% carried viruses with major-DRM to one (12.7%), two (47.3%), or three (5.5%) ARV-families. Most children/adolescents harbored DRM to NNRTI (73.5%) or NRTI (61.2%). Major-DRM to PI was present in 8.3% and minor-DRM to INI in 15%. Dual-class-NRTI+NNRTI resistance appeared in 53.1% of patients. Viruses presented high/intermediate resistance to nevirapine (72.9% patients), efavirenz (70.9%), emtricitabine/lamivudine (47.9%), rilpivirine (41.7%), etravirine (39.6%), doravidine (33.3%), zidovudine (22.9%), among others. Most participants were susceptible to INI and PI. Great diversity of variants was found, with a high rate (40%) of unique recombinants.

Conclusion: The high DRM prevalence observed among HIV-infected children and adolescents in Kinshasa could compromise the 95-95-95-UNAIDS targets in the DRC. It also reinforces the need for routine resistance monitoring for optimal rescue therapy election in this vulnerable population to control the spread of resistant HIV in the country.

Citing Articles

HIV-1 resistance mutations and genetic diversity among children failing antiretroviral treatment in five healthcare facilities in Benin, West Africa.

Dagba Gbessin E, Tchiakpe E, Keke R, Vidal N, Gomgnimbou M, Sina H PLoS One. 2025; 20(1):e0317882.

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Global, regional, and national prevalence of HIV-1 drug resistance in treatment-naive and treatment-experienced children and adolescents: a systematic review and meta-analysis.

Ge L, Luo Y, Li X, Hu Y, Sun L, Bu F EClinicalMedicine. 2024; 77:102859.

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High Drug Resistance Levels Compromise the Control of HIV Infection in Pediatric and Adult Populations in Bata, Equatorial Guinea.

Rodriguez-Galet A, Ventosa-Cubillo J, Bendomo V, Eyene M, Mikue-Owono T, Nzang J Viruses. 2023; 15(1).

PMID: 36680067 PMC: 9864178. DOI: 10.3390/v15010027.

Drug resistance in children and adolescents with HIV in Panama.

Ventosa-Cubillo J, Pinzon R, Gonzalez-Alba J, Estripeaut D, Navarro M, Holguin A J Antimicrob Chemother. 2022; 78(2):423-435.

PMID: 36454248 PMC: 9890268. DOI: 10.1093/jac/dkac407.

Immune surveillance for six vaccinable pathogens using paired plasma and dried blood spots in HIV infected and uninfected children in Kinshasa.

Rodriguez-Galet A, Rubio-Garrido M, Valades-Alcaraz A, Rodriguez-Dominguez M, Galan J, Ndarabu A Sci Rep. 2022; 12(1):7920.

PMID: 35562589 PMC: 9106688. DOI: 10.1038/s41598-022-12052-4.

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