Primary resistance to antiretroviral drugs of HIV strains in Chad: a retrospective investigation by analysis of frozen d
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BRIEF REPORT
Primary resistance to antiretroviral drugs of HIV strains in Chad: a retrospective investigation by analysis of frozen dried blood spot samples A. Keita 1 & N. Djimera 2 & O. Djarma 2 & Y. N’Guyen 3,4 & T. Bourlet 5 & L. Andreoletti 2,4 Received: 15 June 2020 / Accepted: 20 November 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract No data concerning antiretroviral drug’s (ARV) primary resistance mutation rates in Chad are available. We retrospectively analysed frozen-stored dried blood spot samples that were collected from 48 Chadian human immunodeficiency virus (HIV)-1 seropositive patients naïve of ARV. HIV-1 protease and reverse transcriptase genes were successfully sequenced for 24 (60.0%) of the 40 patients displaying a viral load > 1000 copies/ml. Seven (29.2%) displayed mutations conferring resistance against one or more classes of ARV. We evidenced high levels of primary ARV resistance mutations in Chad, but lower than those observed in patients with failure to first-line ARV. Keywords HIV . Chad . Non-nucleoside reverse transcriptase inhibitor . Primary resistance
Introduction Access to highly active antiretroviral drugs (ARV) has significantly reduced human immunodeficiency virus (HIV) transmission in sub-Saharan African countries which still support the highest burden of the pandemic [1]. However, in these countries, access to free but discontinuous first-line antiretroviral regimens consisting almost exclusively of nucleoside reverse transcriptase inhibitors (NRTI) combined with nonnucleoside reverse transcriptase inhibitors (NNRTI) with low genetic barrier to resistance could rapidly lead to the emergence of antiretroviral drugs resistance among ARVtreated patients. In low-income countries of sub-Saharan * L. Andreoletti [email protected] 1
Institut National de Recherche en Santé Publique, Bamako, Mali
2
Service de Maladies infectieuses, Hôpital Le Bon Samaritain, CHU Walia, N’Djamena, Chad
3
Service de Médecine interne, Maladies infectieuses et Immunologie Clinique, Hôpital Robert Debré, CHU Reims, Reims, France
4
Laboratoire de Virologie médicale et moléculaire, Hôpital Robert Debré CHU Reims & EA-4684, Faculté de Médecine, Université Reims Champagne Ardennes, Reims, France
5
EA 3064, Faculté de Médecine, Université Jean Monnet, Saint-Etienne, France
Africa, monitoring of HIV plasma viral load that is recommended by the World Health Organization (WHO) since 2013 and genotyping tests allowing the detection of HIV strains harbouring resistance mutations to antiretroviral drugs are not continuously available. Horizontal or vertical transmission levels of such HIV strains harbouring major resistance mutations to NNRTIs or NRTIs represent a major public health problem and may significantly impact subsequent choices of antiretroviral drugs regimen for newly HIVinfected patients in sub-Saharan African countries. Located in Central Africa, Chad had an estimated HIV seroprevalence of 1.3% among the sexually active population (15–49 years) and ranked
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