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Int. J. Environ. Res. Public Health 2016, 13(6), 568; doi:10.3390/ijerph13060568

Viral Suppression and Resistance in a Cohort of Perinatally-HIV Infected (PHIV+) Pregnant Women

1
Hospital Federal dos Servidores do Estado, Rio de Janeiro 20221-161, Brazil
2
School of Medicine, David Geffen University of California, 10833 Le Conte Avenue, Los Angeles, CA 90095, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Paul B. Tchounwou
Received: 19 April 2016 / Revised: 25 May 2016 / Accepted: 26 May 2016 / Published: 7 June 2016
(This article belongs to the Special Issue Pediatric Infectious Diseases)
View Full-Text   |   Download PDF [250 KB, uploaded 7 June 2016]

Abstract

Our objective was to describe viral suppression and antiretroviral (ARV) resistance mutations in an ongoing cohort of perinatally-infected HIV+ (PHIV+) pregnant women. Descriptive analysis was performed using SPSS 18.0. From 2011 to 2014, we followed 22 PHIV+ pregnant women. Median age at prenatal entry was 19 years (Interquartile range (IQR) 17.6–21.0); 86% had an AIDS diagnosis; 81% had disclosed their HIV status to partner 11. The median age at HIV diagnosis was 8.3 y (IQR 4.0–13.6), the median age at sexual debut was 16 years (IQR 14–18). At the time of prenatal care initiation, four (18%) were on their first antiretroviral treatment (ART), eight (36%) in their second regimen and nine (41%) in their third regimen or beyond, and one had no data. Seventeen of 22 (77%) had HIV-viral load (VL) > 50 copies/mL at prenatal care entry, 16 had a genotyping exam performed. Seventeen of 22 PHIV+ had VL results near delivery: 7/17 (41%) had VL < 50 copies/mL. Among those who had genotyping at prenatal entry, 11/16 (69%) had mutations associated with ARV resistance. The most frequent major mutations were K103N, M184V, T215, M41L, D67N at reverse transcriptase gene and M46, I54V and V82A at protease gene. No vertical transmissions occurred. Management of pregnancy among PHIV+ is challenging. Individualized ART are needed to achieve viral suppression in a highly ART-exposed subpopulation. View Full-Text
Keywords: HIV infection; pregnant women; vertical infection transmission; drug resistance; mutation HIV infection; pregnant women; vertical infection transmission; drug resistance; mutation
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Cruz, M.L.; Santos, E.; Benamor Teixeira, M.L.; Poletti, M.; Sousa, C.; Gouvea, M.I.; Nielsen-Saines, K.; João, E. Viral Suppression and Resistance in a Cohort of Perinatally-HIV Infected (PHIV+) Pregnant Women. Int. J. Environ. Res. Public Health 2016, 13, 568.

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