Pretreatment and Acquired Drug Resistance in Children With Human Immunodeficiency Virus Type 1 in Jos, Nigeria

Area of Science:

• * Virology and infectious diseases
• * Pediatric infectious disease research
• * Public health and epidemiology

Background:

• * First-line antiretroviral therapy (ART) failure in children with HIV type 1 (HIV-1) is a growing concern.
• * Understanding drug resistance patterns is crucial for effective treatment strategies in pediatric HIV management.
• * Limited data exists on pretreatment and acquired HIV drug resistance in children in Nigeria.

Purpose of the Study:

• * To determine the prevalence of pretreatment and acquired HIV drug resistance mutations in children with HIV-1 in Jos, Nigeria.
• * To identify specific drug resistance patterns associated with first-line ART failure in this population.
• * To inform recommendations for optimizing second-line treatment strategies.

Main Methods:

• * Retrospective analysis of HIV drug resistance mutations.
• * Genotypic resistance testing on samples from children with HIV-1.
• * Analysis of treatment regimens and treatment failure data.

Main Results:

• * High prevalence of pretreatment (48%) and acquired (76%) HIV drug resistance mutations observed.
• * The majority of children (71%) who failed first-line ART were on a nevirapine-containing regimen.
• * Specific resistance mutations associated with non-nucleoside reverse transcriptase inhibitors (NNRTIs) were prevalent.

Conclusions:

• * Significant levels of HIV drug resistance necessitate improved monitoring and testing strategies.
• * Nevirapine-based first-line regimens are associated with high rates of treatment failure due to resistance.
• * Enhanced access to HIV drug resistance testing is critical for guiding optimal second-line ART selection in children in Nigeria.