Abstract:
The World Health Organization (WHO) recommends periodic surveillance of transmitted drug resistance (TDR)
in communities in which antiretroviral therapy (ART) has been scaled-up for greater than 3 years. We conducted
a survey of TDR mutations among newly detected HIV-infected antiretroviral (ARV)-naive pregnant women.
From May 2010 to March 2012, 38 ARV-naive pregnant women were recruited in three hospitals in Jos, Plateau
state, north central Nigeria. Eligible subjects were recruited using a modified version of the binomial sequential
sampling technique recommended by WHO. HIV-1 genotyping was performed and HIV-1 drug resistance
mutations were characterized according to the WHO 2009 surveillance drug resistance mutation (SDRM) list.
HIV subtypes were determined by phylogenetic analysis. The women’s median age was 25.5 years; the median
CD4 + cell count was 317 cells/ll and the median viral load of 16 was 261 copies/ml. Of the 38 samples tested, 34
(89%) were successfully genotyped. The SDRM rate was <5% for all ART drug classes, with 1/34 (2.9%) for
NRTIs/NNRTIs and none for protease inhibitors 0/31 (0%). The specific SDRMs detected were M41L for
nucleoside reverse transcriptase inhibitors (NRTIs) and G190A for nonnucleoside reverse transcriptase inhibitors
(NNRTIs). HIV-1 subtypes detected were CRF02_AG (38.2%), G¢ (41.2%), G (14.7%), CRF06-CPX (2.9%), and a
unique AG recombinant form (2.9%). The single ARV-native pregnant woman with SDRMs was infected with
HIV-1 subtype G¢. Access to ART has been available in the Jos area for over 8 years. The prevalence of TDR
lower than 5% suggests proper ART administration, although continued surveillance is warranted.
