Observed HIV drug resistance associated mutations amongst naïve immunocompetent children in Yaounde, Cameroon

Ikomey, George Mondinde ; Assoumou, Marie Claire Okomo ; Gichana, Josiah Otwoma ; Njenda, Duncan ; Mikasi, Sello Given ; Mesembe, Martha ; Lyonga, Emilia ; Jacobs, Graeme Brendon (2017)

CITATION: Ikomey, G. M., et al. 2017. Observed HIV drug resistance associated mutations amongst naïve immunocompetent children in Yaounde, Cameroon. GERMS, 7(4):178-185, doi:10.18683/germs.2017.1124.

The original publication is available at http://www.germs.ro/en/Homepage/

Article

Introduction: The emergence of drug resistance mutations (DRMs) has been a major threat for successful lifelong combination antiretroviral therapy (cART), especially for HIV-vertically infected children within the context of the prevention of mother-to-child transmission (PMTCT). This study aimed to evaluate DRMs amongst immune competent treatment-naïve children in Cameroon. Methods: A cross-sectional study was conducted between 2015 and 2016 amongst 55 proxy consented HIV-1 positive children, aged 9 months to 6 years. They were all immune competent, cART naïve and with unknown history of PMTCT. CD4 cell counts and genotypic drug resistance testing were performed using standard methods. Results: Levels of DRMs to protease (PR) inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs) and non-NRTIs were 27.6%, 3.7% and 40.7%, respectively. Only minor DRMs were observed for PR. The observed mutations for NRTI were K65R, T215I and K219E (33.0% each) and for NNRTI: V106M, Y181C and Y188H (6.0% each). Only minor accessory mutations were found in the integrase (IN) region. Conclusion: Despite widely available cART we still observe naïve HIV children, especially from the rural communities. We observe that a proportion of study participants had HIV-1 drug resistance associated mutations (RAMs). Data generated could help strengthen the current PMTCT programmes within the country. There is a need to upscale approaches for drug resistance testing for children in Cameroon and many other resource-limited settings.

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