High viremia and low level of transmitted drug resistance in anti-retroviral therapy-naïve perinatally-infected children and adolescents with HIV-1 subtype C infection

BMC Infectious Diseases

Anita Shet¹  Ayesha De Costa²  Pravat Nalini Sahoo³  Ujjwal Neogi³ 

[1] Department of Paediatrics, St. John’s National Academy of Health Sciences, Bangalore, 560034, India;Division of Global Health, Karolinska Institutet, Stockholm, Sweden;Division of Clinical Virology, Department of Microbiology, St. John’s National Academy of Health Sciences, Bangalore, India

关键词: India;    Viral dynamics;    Subtype C;    HIV-1 perinatal transmission;   

Others  :  1175135
DOI  :  10.1186/1471-2334-12-317

 received in 2012-06-06, accepted in 2012-11-20,  发布年份 2012

【 摘 要 】

Background

High plasma viremia in HIV-1 infection is associated with rapid CD4 cell decline and faster disease progression. Children with HIV infection have high viral loads, particularly in early childhood. In this study we sought to understand the relationship between duration of HIV-1 infection and viral dynamics among perinatally-infected children and adolescents in India along with transmitted drug resistance in this population.

Methods

During 2007–2011, cross-sectional samples were collected from ART-naïve children (n = 105) with perinatally-acquired HIV infection, aged 2–16 years from Bangalore, India. CD4 counts, viral load and in-house genotyping were performed and transmitted drug resistance mutations were identified using the World Health Organization recommendations for Surveillance of Drug Resistance Mutations (SDRM_2009) list.

Results

Among 105 children studied, 73.3% (77/105) were asymptomatic, but had a median viral load of 5.24 log copies/mL (IQR 4.62-5.66). In the adolescent age group, 54% (21/39) had high levels of viremia (median 5.14 log copies/mL) but were asymptomatic. HIV-1 subtyping identified 98% strains (103/105) as subtype C; one A1 and one unique recombinant form (URF). Transmitted NRTI resistance was 1.9% (2/105); NNRTI resistance was 4.8% (5/105) and overall prevalence of transmitted drug resistance was 5.7% (6/105).

Conclusions

The high burden of plasma viremia found among untreated asymptomatic adolescents needs to be addressed both from an individual angle to halt disease progression, and from a public health perspective to arrest horizontal transmission. The low level of transmitted drug resistance among perinatally-infected children is reassuring; however with improving ART access globally, regular genotyping surveillance is indicated.

【 授权许可】

   
2012 Neogi et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

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