Abstract:
Background:
Access to antiretroviral therapy (ART) has increased dramatically in Sub-Saharan Africa. In Kenya,
560,000 people had access to ART by the end of 2011. This scaling up of ART has raised challenges to the Kenyan
health system due to emergence of drug resistant vir
uses among those on treatment and possible onward
transmission. To counter this, and come up with an effective treatment strategy, it has become vital to determine
baseline mutations associated with drug resistance among the circulating strains of HIV-1in Kenya.
Methods:
The prevalence of mutations associated with drug resistance in HIV-1 protease (PR) and reverse transcriptase
(RT) regions from 188 HIV-1 infected treatment-naïve pregnant women was investigated in Kapsabet, Nandi Hills and
Kitale district hospitals of Kenya. Blood samples were collected between April 2005 and June 2006. The HIV-1 pol gene
was amplified using primers for HIV-1 PR and RT and sequenced using the BigDye chemistry. The mutations were
analyzed based on the IAS algorithm as well as the Stanford University HIV Drug Resistance Database.
Results:
Based on the PR and RT sequences, HIV-1 subtypes A1 (n=117, 62.2%), A2 (n=2, 1.1%), D (n=27, 14.4%),
C (n=13, 6.9%), G (n=3, 1.6%), and possible recombinants (n=26, 13.8%) were detected. Mutations associated with
nucleoside reverse transcriptase inhibitors (NRTI) and non-nucleoside RTI (NNRTI)-resistance were detected in 1.6%
(3 of 188) and 1.1% (2 of 188), respectively. Mutations associated with PI resistance were detected in 0.5% (1 of 188) of
the study population.
Conclusion:
The prevalence of drug resistance among drug-naïve pregnant women in rural North Rift, Kenya in 2006
was 3.2%. Major drug resistance mutations associated with PIs, NRTIs and NNRTIs do exist among treatment-naïve
pregnant women in North Rift, Kenya. There is a need for consistent follow-up of drug-naïve individuals in this region
to determine the impact of mutations on treatment outcomes.
