Premium
Incident and long‐term HIV‐1 infection among pregnant women in Brazil: Transmitted drug resistance and mother‐to‐child transmission
Author(s) -
Lima Yanna Andressa Ramos,
Cardoso Ludimila Paula Vaz,
Reis Mônica Nogueira da Guarda,
Stefani Mariane Martins Araújo
Publication year - 2016
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.24540
Subject(s) - seroconversion , medicine , pregnancy , serology , transmission (telecommunications) , population , virology , obstetrics , drug resistance , immunology , human immunodeficiency virus (hiv) , antibody , biology , genetics , microbiology and biotechnology , environmental health , electrical engineering , engineering
Primary infection, seroconversion, and transmitted drug resistance (TDR) during pregnancy may influence the risk of mother‐to‐child‐transmission (MTCT) of HIV‐1 infection. This study estimated recent seroconversion, TDR rates, HIV‐1 subtypes and pregnancy outcomes among 95 recently diagnosed, antiretroviral (ARV)‐naïve pregnant women recruited during antenatal care in central western Brazil. Recent seroconversion was defined by BED‐capture enzyme immunoassay (<155 days) and ambiguous nucleotides base calls (<1 year) in pol sequences (protease‐PR and reverse transcriptase‐RT regions). TDR was evaluated by the Calibrated Population Resistance tool. HIV‐1 subtypes were defined by REGA and phylogenetic analyses. The median age of participants was 25 years; the median gestational age at diagnosis was 20.5 weeks. Based on serology and sequence polymorphism, recent infection was identified in 11.6% (11/95) and, 9 of them (82%), probably seroconverted during pregnancy; one MTCT case was observed among them. Three cases of stillbirth were observed among chronic infected patients (3.6%; 3/84). Moderate rate of TDR was observed (9/90, 10%, CI95% 4.7–18.1%). Subtype B was 60% (54/90), 13.3% (12/90) was subtype C, 6.7% (6/90) was subtype F1. Recombinant B PR /F1 RT and F1 PR /B RT viruses comprised 15.5% (14/90); B PR /C RT mosaics represented 4.4% (4/90). Seroconversion during pregnancy, late presentation to antenatal care and moderate TDR identified in this study represent significant challenges for the MTCT elimination. J. Med. Virol. 88:1936–1943, 2016 . © 2016 Wiley Periodicals, Inc.