Trends in drug resistance mutations among HIV-1-infected children in Kenya from 2014 to 2018

• Published in: Preventive Medicine Research Vol. 1; no. 5; pp. 64 - 77
• Main Authors: Kageha, Sheila, Bi, Xiuqiong, Nguyen, Quynh T., Lihana, Raphael, Olungae, Dama, Kinyua, Joyceline G., Lel, Rency J., Mwangi, Joseph, Okoth, Vincent, Saina, Matilda, Chu, Son T., Mwau, Matilu M., Songok, Elijah M., Tokoro, Masaharu, Ichimura, Hiroshi
• Format: Journal Article
• Language: English
• Published: Japanese Society of Preventive Medicine 13.03.2024
• Subjects: antiretroviral therapy (ART); drug resistance mutation (DRM); HIV-1
• ISSN: 2758-7916
• DOI: 10.60219/pmr.1.5_64

Background: Most children access early human immunodeficiency virus type 1 (HIV-1) diagnosis in Kenya. However, the detection frequency of HIV-1 drug-resistance mutations (DRMs) among the children, main cause of their antiretroviral therapy (ART) failure, has not been well known. This study aimed at investigating the DRM trends in newly HIV-1-diagnosed Kenyan children between 2014 and 2018.Methods: Dried blood spots (DBS) were collected from children with HIV-1 under 18 months of age through the Kenya Early Infant Diagnosis program in 2014, 2017 and 2018 (n = 57, 70, and 50, respectively). HIV-1 proviral DNA was extracted from the DBS and analyzed genetically. DRMs were checked following the IAS-USA list and/or Stanford HIV-1DB PROGRAM algorithm.Results: Among the Kenyan children with HIV-1, DRMs were detected in 57.9% [nucleoside reverse transcriptase inhibitors (NRTI)-DRM/non-NRTI (NNRTI)-DRM: 22.8%/57.9%] in 2014, 54.3% (11.4%/54.3%) in 2017, and 58.0% (14.0%/58.0%) in 2018. All children who had NRTI-DRMs had NNRTI-DRMs. As for NNRTI-DRMs, Y181C was found more in 2014 than 2017/2018 (28.1% vs. 7.1%/6.0%, p = 0.0002), whereas K103N/S more in 2017/2018 than 2014 (37.1%/34.0% vs. 17.5%, p = 0.026). Among the children with DRMs, 94.9% and 67.7% showed high-level resistance to nevirapine and efavirenz (NNRTI), respectively. The mother’s PMTCT history was significantly associated with the NNRTI-DRMs in all years.Conclusion: Majority of newly HIV-1-diagnosed Kenyan children continuously harbored DRMs between 2014 and 2018, which probably originated from their mothers’ PMTCT. Checking DRMs before starting ART and/or using non-NNRTI-containing regimen for ART should be considered in children with HIV-1 in Kenya.