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Article

Characterizing HIV-1 Genetic Subtypes and Drug Resistance Mutations among Children, Adolescents and Pregnant Women in Sierra Leone

1
Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
2
Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA
3
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
4
Department of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone
5
Ministry of Health and Sanitation, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone
6
Group of Virology and Pathogenesis, Galicia Sur Health Research Institute (IIS Galicia Sur), Complexo Hospitalario Universitario de Vigo, SERGAS-UVigo, 36213 Vigo, Spain
7
Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal
*
Author to whom correspondence should be addressed.
Academic Editor: Victor Asensi
Genes 2021, 12(9), 1314; https://doi.org/10.3390/genes12091314
Received: 23 June 2021 / Revised: 15 August 2021 / Accepted: 24 August 2021 / Published: 26 August 2021
Human immunodeficiency virus (HIV) drug resistance (HIVDR) is widespread in sub-Saharan Africa. Children and pregnant women are particularly vulnerable, and laboratory testing capacity remains limited. We, therefore, used a cross-sectional design and convenience sampling to characterize HIV subtypes and resistance-associated mutations (RAMs) in these groups in Sierra Leone. In total, 96 children (age 2–9 years, 100% ART-experienced), 47 adolescents (age 10–18 years, 100% ART-experienced), and 54 pregnant women (>18 years, 72% ART-experienced) were enrolled. Median treatment durations were 36, 84, and 3 months, respectively, while the sequencing success rates were 45%, 70%, and 59%, respectively, among children, adolescents, and pregnant women. Overall, the predominant HIV-1 subtype was CRF02_AG (87.9%, 95/108), with minority variants constituting 12%. Among children and adolescents, the most common RAMs were M184V (76.6%, n = 49/64), K103N (45.3%, n = 29/64), Y181C/V/I (28.1%, n = 18/64), T215F/Y (25.0%, n = 16/64), and V108I (18.8%, n = 12/64). Among pregnant women, the most frequent RAMs were K103N (20.6%, n = 7/34), M184V (11.8%, n = 4/34), Y181C/V/I (5.9%, n = 2/34), P225H (8.8%, n = 3/34), and K219N/E/Q/R (5.9%, n = 2/34). Protease and integrase inhibitor-RAMs were relatively few or absent. Based on the genotype susceptibility score distributions, 73%, 88%, and 14% of children, adolescents, and pregnant women, respectively, were not susceptible to all three drug components of the WHO preferred first-line regimens per 2018 guidelines. These findings suggest that routine HIVDR surveillance and access to better ART choices may improve treatment outcomes in Sierra Leone. View Full-Text
Keywords: HIV; drug resistance; children; adolescents; pregnant women; resource-limited settings; Sierra Leone HIV; drug resistance; children; adolescents; pregnant women; resource-limited settings; Sierra Leone
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MDPI and ACS Style

Yendewa, G.A.; Lakoh, S.; Yendewa, S.A.; Bangura, K.; Tabernilla, A.; Patiño, L.; Jiba, D.F.; Vandy, A.O.; Massaquoi, S.P.; Osório, N.S.; Deen, G.F.; Sahr, F.; Salata, R.A.; Poveda, E. Characterizing HIV-1 Genetic Subtypes and Drug Resistance Mutations among Children, Adolescents and Pregnant Women in Sierra Leone. Genes 2021, 12, 1314. https://doi.org/10.3390/genes12091314

AMA Style

Yendewa GA, Lakoh S, Yendewa SA, Bangura K, Tabernilla A, Patiño L, Jiba DF, Vandy AO, Massaquoi SP, Osório NS, Deen GF, Sahr F, Salata RA, Poveda E. Characterizing HIV-1 Genetic Subtypes and Drug Resistance Mutations among Children, Adolescents and Pregnant Women in Sierra Leone. Genes. 2021; 12(9):1314. https://doi.org/10.3390/genes12091314

Chicago/Turabian Style

Yendewa, George A., Sulaiman Lakoh, Sahr A. Yendewa, Khadijah Bangura, Andrés Tabernilla, Lucia Patiño, Darlinda F. Jiba, Alren O. Vandy, Samuel P. Massaquoi, Nuno S. Osório, Gibrilla F. Deen, Foday Sahr, Robert A. Salata, and Eva Poveda. 2021. "Characterizing HIV-1 Genetic Subtypes and Drug Resistance Mutations among Children, Adolescents and Pregnant Women in Sierra Leone" Genes 12, no. 9: 1314. https://doi.org/10.3390/genes12091314

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