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most prevalent (97 per cent), followed by subtype A1 (1.2 per cent), mosaic recombinant forms (1.2 per cent), subtype G (0.5 per cent), and subtype D (0.2 per cent). Over 60 per cent of the children had at least one mutation associated to drug resistance to NRTI/NNRTI. As expected a high frequency of mutations to NNRT (52.9 per cent) in comparison to NRTIs (11.4 per cent) due to the low genetic barrier of this class of drugs was observed. For NNRTI, K103N, Y181C, E138A, and G190A were most common whereas for the NRTI, M184V was the most common. Maternal prophylaxis with HAART was significantly (P< 0.05, OR 2.41) associated with the emergence of drug resistance mutation to NRTI in HIV infected children. In conclusion, the high level of transmitted-resistant viruses observed in this study suggests that political strategies to enhance the level of adherence in maternal HAART should be taken into account. This is an important consideration due to the fact that Mozambique recently implemented the integrated PMTCT option Bþapproach. Low adherence in such a treatment context may undermine de efficacy of first-line option in the country. Continuing surveillance studies among HIV infected children remains critical to monitor the impact of PMTCT strategies. Furthermore, current results highlight the need to reinforce adherence counseling with appropriate follow up.

A19 The impact of HIV-1 on the evolution of Mycobacterium tuberculosis