Emergence of HIV-1 drug resistance mutations in mothers on treatment with a history of prophylaxis in Ghana
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RESEARCH
Open Access
Emergence of HIV-1 drug resistance mutations in mothers on treatment with a history of prophylaxis in Ghana Alexander Martin-Odoom1* , Charles Addoquaye Brown1, John Kofi Odoom2, Evelyn Yayra Bonney2, Nana Afia Asante Ntim2, Elena Delgado3, Margaret Lartey4, Kwamena William Sagoe1, Theophilus Adiku1 and William Kwabena Ampofo2
Abstract Background: Antiretrovirals 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. Methods: Genotypic 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. Results: Participants 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%). Conclusion: In Ghana initiation of uninterrupted treatment upon diagnosis, coupled with drug resistance testing, would produce a better treatment outcome for HIV-1 positive pregnant women. Keywords: Antiretroviral therapy, Phylogenetic analysis, Drug resistance profiles, Treatment outcome
Background Antiretroviral therapy (ART) was started in Ghana in 2003 and has gone through a number of revisions to provide appropriate health care and support for HIV positive persons across the whole of Ghana [1]. The National AIDS/ STI Control Programme (NACP) of the Ghana Health Service implemented various research-backed interventions to monitor drug resistance known to arise in HIV patients through the use of the Antiretrovirals (ARVs) [2]. The * Correspondence: [email protected]; [email protected] 1 Department of Medical Laboratory Sciences, School of Biomedical & Allied Health Sciences, College of Health Sciences, University of Ghana, P.O. Box KB 143, Korle Bu, Accra, Ghana Full list of author information is available at the end of the article
emergence of HIV-1 drug resistance viral strains is a major obstacle in the effective manag
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