Surveillance of HIV-1 transmitted drug resistance in Guinea in the context of the Ebola Outbreak 2014-2015

Clinical monitoring of HIV patients is essential to minimize the accumulation and transmission of resistance strains due to inadequate antiretroviral treatment (ART). HIV-1 transmitted drug-resistance (TDR) rate was determined in the context of decentralization of ART and care in Senegal, and the Ebola outbreak in Conakry, Guinea. Antiretroviral-naïve patients were enrolled using an adaptation of the WHO drug-resistance threshold survey method. Sixty-nine and 50 patients, respectively from Senegal and Guinea, were enrolled between January-March 2015 and August-September 2015. Genotyping of HIV-1 pol sequences was successfully performed on plasma specimens from 54/69 (78.2%) and dried blood-spots from 31/50 (62.0%) patients to identify WHO surveillance drug resistance mutations. In Senegal, TDR rate was 0% for mean-time-since-diagnosis of 4.08±3.53 years. In Guinea, one patient harbored mutation NNRTI-G190A, another NRTIs-M184V/T215F and NNRTI-K103N. However, TDR rate at this site could not be ascertained due to low sample size. Phylogenetic analysis confirmed CRF02_AG dominance in Senegal (62.96%) and Guinea (77.42%). TDR rate remains low in Senegal suggesting improved control measures. In both settings, however, continued surveillance of TDR is required and should be done closest to transmission/diagnosis time and with a larger sample size.