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An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
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Drug resistance in children and adolescents with HIV in Panama

Judit Ventosa-Cubillo1, Ramón Pinzón2, José María González-Alba3

  • 1HIV-1 Molecular Epidemiology Laboratory, Microbiology and Parasitology Department, Hospital Ramón y Cajal-IRYCIS and CIBERESP-ISCIII-RITIP-CoRISpe-PLANTAIDS-CYTED, Madrid, Spain.

The Journal of Antimicrobial Chemotherapy
|December 1, 2022
PubMed
Abstract

Insights

Drug resistance mutations (DRMs) are common in HIV-infected children in Panama, particularly to nucleoside and non-nucleoside reverse transcriptase inhibitors. Routine monitoring is crucial for effective treatment selection in this population.

Area of Science:

  • Virology
  • Infectious Diseases
  • Public Health

Background:

  • Inadequate HIV resistance monitoring in Latin America contributes to the spread of drug-resistant strains, impacting antiretroviral therapy (ART) effectiveness.
  • Understanding the prevalence of drug resistance mutations (DRMs) in pediatric populations is critical for optimizing treatment strategies.

Purpose of the Study:

  • To describe the prevalence of HIV-1 drug resistance mutations (DRMs) in HIV-infected pediatric patients in Panama.
  • To analyze antiretroviral (ARV) susceptibility and phylogenetic characteristics of HIV-1 variants in this cohort.

Main Methods:

  • Plasma samples were collected from 76 HIV-infected children and adolescents in Panama during 2018-2019.
  • HIV-1 pol gene sequencing was performed for DRM analysis.
  • Antiretroviral susceptibility was predicted using the Stanford HIV Drug Resistance Database, and phylogenetic characterization was conducted.

Main Results:

  • HIV-1 pol sequences were obtained from 67 (88.2%) participants.
  • Among treated patients (n=62), 54.8% harbored resistant strains, with significant DRMs against nucleoside reverse transcriptase inhibitors (NRTIs) (58.5%) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) (39%).
  • High resistance was observed to emtricitabine/lamivudine (48.9% each) and efavirenz/nevirapine (33.3% each), while susceptibility to protease inhibitors (91.3%) and integrase strand transfer inhibitors (88.1%) remained high.

Conclusions:

  • A high prevalence of DRMs to NRTIs and NNRTIs was found in treated HIV-infected children and adolescents in Panama.
  • The study highlights the urgent need for routine resistance monitoring in this vulnerable pediatric population to guide optimal rescue therapy selection.

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