Ikomey George Mondinde, Assoumou Marie Claire Okomo, Gichana Josiah Otwoma, Njenda Duncan, Mikasi Sello Given, Mesembe Martha, Lyonga Emilia, Jacobs Graeme Brendon
PhD, Center for the Study and Control of Communicable Diseases (CSCCD), Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 8445, Yaoundé, Cameroon.
PhD, Center for the Study and Control of Communicable Diseases (CSCCD) Faculty of Medicine and Biomedical Sciences, University of Yaoundé 1, PO Box 8445, Yaoundé, Cameroon.
Germs. 2017 Dec 5;7(4):178-185. doi: 10.18683/germs.2017.1124. eCollection 2017 Dec.
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.
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.
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.
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.
耐药性突变（DRMs）的出现一直是成功进行终身联合抗逆转录病毒疗法（cART）的重大威胁，尤其是对于预防母婴传播（PMTCT）背景下的垂直感染艾滋病毒儿童。本研究旨在评估喀麦隆免疫功能正常且未接受过治疗的儿童中的耐药性突变情况。
2015年至2016年期间，对55名经代理同意的9个月至6岁的HIV-1阳性儿童进行了横断面研究。他们均免疫功能正常，未接受过cART治疗，且母婴传播史不明。使用标准方法进行CD4细胞计数和基因型耐药性检测。
对蛋白酶（PR）抑制剂（PIs）、核苷类逆转录酶抑制剂（NRTIs）和非核苷类逆转录酶抑制剂（NNRTIs）的耐药性突变水平分别为27.6%、3.7%和40.7%。PR仅观察到少量耐药性突变。NRTI观察到的突变是K65R、T215I和K219E（各占33.0%），NNRTI的突变是V106M、Y181C和Y188H（各占6.0%）。整合酶（IN）区域仅发现少量辅助性突变。
尽管cART广泛可得，但我们仍观察到未接受过治疗的艾滋病毒儿童，尤其是来自农村社区的儿童。我们观察到一部分研究参与者存在HIV-1耐药相关突变（RAMs）。所产生的数据有助于加强该国目前的PMTCT项目。有必要扩大喀麦隆及许多其他资源有限地区儿童耐药性检测的方法。
