Background:
The persistence of HIV-1 in latent reservoirs poses a significant challenge to eradicating HIV-1 infection. Despite antiretroviral therapy (ART), pro-viral DNA remains in viral reservoirs. The aim of our study was to characterize the HIV-1 drug resistance mutations archived in cellular reservoirs of ART-treated adolescents vertically infected with HIV in the Centre Region of Cameroon.
Methods:
We collected samples from vertically infected adolescents living in Yaoundé and surroundings. We assessed the immuno-virological response to ART and identified the most prevalent archived drug resistance mutations in reservoirs using amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). Statistical analyses were performed using Graphpad Prism, with Pearson's Chi-Square test for association between categorical variables and Spearman's Chi-Square test for correlations. A p-value < 0.05 was considered statistically significant.
Results:
The study included 40 adolescents, mostly male (55%), with a median age of 15.5 years. Median CD4 count was 639 cells/mm3, and the median plasmatic viral load was 40 copies/ml. The most prevalent archived mutation was K103N, an NNRTI-associated mutation (28/40 or 70%), followed by M184V, an NRTI-associated mutation (11/40 or 27.5%). A significant association (p=0.0001) was observed between plasmatic viremia and archived mutations in the reservoirs (HIV-1 pro-viral DNA).
Conclusion:
Despite effective ART with successful immunological and virological responses, our study found a high proportion of archived NNRTI-associated drug resistance mutations in vertically HIV-1 infected adolescents in Cameroon. These findings call for a swift transition to ART regimens excluding NNRTIs, as recommended by WHO, to ensure long-term successful management of vertically HIV-1 infected adolescents in our settings.
