Molecular characterisation of transmitted HIV- 1C from HIV infected mothers to their infants in Botswana

Molecular characterisation of transmitted HIV- 1C from HIV infected mothers to their infants in Botswana

HIV-1 drug resistance genotyping has become a standard of care in HIV-1 infection management in developed countries but availability remains infrequent in the developing world. In Botswana, all HIV-1C positive pregnant women are given NNRTI-based antiretroviral preventative therapy to prevent mother to child transmission of HIV. History of NNRTI exposure is used to identify children who should initiate lopinavir/ritonavir (LPV/r)-based Antiretroviral Therapy (ART).

In Botswana, National guidelines on HIV/AIDS treatment 2013 state that all positive infants should be enrolled in lopinavir/ritonavir (LPV/r)-based antiretroviral therapy without pre-treatment HIV drug resistance mutation. If HIV-1 drug resistance mutations prior to ART initiation in infants was known, proper drugs could be selected for them.

This study asks:

  1. what is the frequency of HIV drug resistance mutation in newly diagnosed infants under 18 months in Botswana; and
  2. what is the prevalence of NNRTI, NRTI and PI drug resistance mutation in newly diagnosed infants in Botswana?

The study will include samples of newly diagnosed HIV-1 positive infants who are less than 18 months, tested in Botswana Harvard HIV Reference Laboratory and their maternal samples. Plasma/Buffy coat/DBS samples will be extracted using the EZ1 machine following manufacturer’s instructions. Extracted nucleic acid will be run on long range PCR method which amplifies 80% of HIV-1 genome to determine HIV-1 drug resistance mutations.