HIV in pregnant women group in the Republic of Guinea: frequency and genetic characteristics

The aim of this study was to assess the prevalence and study of the molecular genetic characteristics of the human immunodeficiency virus in pregnant women of the Republic of Guinea.

Materials and methods. The material for the study was blood plasma samples of 972 pregnant women from the Republic of Guinea. The patients were examined for the presence of HIV infection serological (Ag+Ab) and molecular markers (RNA). For patients with a positive PCR result and a sufficient viral load (>500 c/ml), the genetic sequences of the pol gene fragment responsible for the synthesis of pro and rev proteins were obtained by Sanger sequencing. These sequences were used for phylogenetic analysis and examined for drug resistance mutations.

Results and discussion. 12.96% of patients was positive in ELISA. Among women who were positive in ELISA, RNA was detected in 76.98% of cases, however, in 11 cases, RNA was detected in patients without serological markers of HIV infection, so the incidence of HIV RNA in the entire surveyed population was 11.11%. In the vast majority of cases, the circulating recombinant form 02_AG is found. Based on the analysis, we assume a significant contribution of recombinant forms of HIV to the genetic diversity of the virus in the region under study.

The incidence of DR mutations was quite high (26.80%). The most frequent substitutions were in position 20 of the protease (70.10%, 95% CI 59.96–78.98%), of which the K20I mutation was dominant. In addition, the L10I/V mutation was relatively common, increasing the replication of viruses with other PI resistance mutations. Among the mutations associated with HIV resistance to NNRTIs, a non-polymorphic mutation V179T was found.

Conclusion. An important factor influencing the effectiveness of Prevention of Mother to Child Transmission identified in this study was the high prevalence of PDR among pregnant women in Guinea. The high prevalence of drug resistance mutations found in this study in pregnant women, as well as in ART-naive women, indicates that current regimens in Guinea are insufficient to prevent vertical HIV infection.

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