{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T20:15:22Z","timestamp":1788984922678,"version":"build-2803163510"},"reference-count":68,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T00:00:00Z","timestamp":1671580800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004892","name":"Fundaci\u00f3n Familia Alonso","doi-asserted-by":"publisher","award":["2021\/SUN\/0000500022"],"award-info":[{"award-number":["2021\/SUN\/0000500022"]}],"id":[{"id":"10.13039\/501100004892","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004892","name":"Fundaci\u00f3n Familia Alonso","doi-asserted-by":"publisher","award":["FI19\/00103"],"award-info":[{"award-number":["FI19\/00103"]}],"id":[{"id":"10.13039\/501100004892","id-type":"DOI","asserted-by":"publisher"}]},{"name":"ISCIII","award":["2021\/SUN\/0000500022"],"award-info":[{"award-number":["2021\/SUN\/0000500022"]}]},{"name":"ISCIII","award":["FI19\/00103"],"award-info":[{"award-number":["FI19\/00103"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>A lack of HIV viral load (VL) and HIV drug resistance (HIVDR) monitoring in sub-Saharan Africa has led to an uncontrolled circulation of HIV-strains with drug resistance mutations (DRM), compromising antiretroviral therapy (ART). This study updates HIVDR data and HIV-1 variants in Equatorial Guinea (EG), providing the first data on children\/adolescents in the country. From 2019\u20132020, 269 dried blood samples (DBS) were collected in Bata Regional Hospital (EG) from 187 adults (73 ART-na\u00efve\/114 ART-treated) and 82 children\/adolescents (25 HIV-exposed-ART-na\u00efve\/57 ART-treated). HIV-1 infection was confirmed in Madrid by molecular\/serological confirmatory tests and ART-failure by VL quantification. HIV-1 pol region was identified as transmitted\/acquired DRM, predicted antiretroviral susceptibility (Stanfordv9.0) and HIV-1 variants (phylogeny). HIV infection was confirmed in 88.1% of the individuals and virological failure (VL &gt; 1000 HIV-1-RNA copies\/mL) in 84.2\/88.9\/61.9% of 169 ART-treated children\/adolescents\/adults. Among the 167 subjects with available data, 24.6% suffered a diagnostic delay. All 125 treated had experienced nucleoside retrotranscriptase inhibitors (NRTI); 95.2% were non-NRTI (NNRTI); 22.4% had experienced integrase inhibitors (INSTI); and 16% had experienced protease inhibitors (PI). At sampling, they had received 1 (37.6%), 2 (32%), 3 (24.8%) or 4 (5.6%) different ART-regimens. Among the 43 treated children\u2013adolescents\/37 adults with sequence, 62.8\/64.9% carried viruses with major-DRM. Most harbored DRM to NNRTI (68.4\/66.7%), NRTI (55.3\/43.3%) or NRTI+NNRTI (50\/33.3%). One adult and one child carried major-DRM to PI and none carried major-DRM to INSTI. Most participants were susceptible to INI and PI. DRM was absent in 36.2% of treated patients with VL &gt; 1000 cp\/mL, suggesting adherence failure. TDR prevalence in 59 ART-na\u00efve adults was high (20.3%). One-half (53.9%) of the 141 subjects with pol sequence carried CRF02_AG. The observed high rate of ART-failure and transmitted\/acquired HIVDR could compromise the 95-95-95-UNAIDS targets in EG. Routine VL and resistance monitoring implementation are mandatory for early detection of ART-failure and optimal rescue therapy selection ART regimens based on PI, and INSTI can improve HIV control in EG.<\/jats:p>","DOI":"10.3390\/v15010027","type":"journal-article","created":{"date-parts":[[2022,12,22]],"date-time":"2022-12-22T02:06:14Z","timestamp":1671674774000},"page":"27","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["High Drug Resistance Levels Compromise the Control of HIV Infection in Pediatric and Adult Populations in Bata, Equatorial Guinea"],"prefix":"10.3390","volume":"15","author":[{"given":"Ana","family":"Rodr\u00edguez-Galet","sequence":"first","affiliation":[{"name":"HIV-1 Molecular Epidemiology Laboratory, Microbiology and Parasitology Department, Hospital Ram\u00f3n y Cajal-IRYCIS and CIBEREsp-RITIP-CoRISpe, 20834 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judit","family":"Ventosa-Cubillo","sequence":"additional","affiliation":[{"name":"HIV-1 Molecular Epidemiology Laboratory, Microbiology and Parasitology Department, Hospital Ram\u00f3n y Cajal-IRYCIS and CIBEREsp-RITIP-CoRISpe, 20834 Madrid, Spain"},{"name":"Fundaci\u00f3n Estatal, Salud, Infancia y Bienestar Social (CSAI), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ver\u00f3nica","family":"Bendomo","sequence":"additional","affiliation":[{"name":"Unidad de Referencia de Enfermedades Infecciosas (UREI), Hospital Regional de Bata, Bata 88240, Equatorial Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Eyene","sequence":"additional","affiliation":[{"name":"Unidad de Referencia de Enfermedades Infecciosas (UREI), Hospital Regional de Bata, Bata 88240, Equatorial Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Mikue-Owono","sequence":"additional","affiliation":[{"name":"Laboratorio de An\u00e1lisis Cl\u00ednicos, Hospital Regional de Bata, Bata 88240, Equatorial Guinea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jes\u00fas","family":"Nzang","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Estatal, Salud, Infancia y Bienestar Social (CSAI), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Policarpo","family":"Ncogo","sequence":"additional","affiliation":[{"name":"Fundaci\u00f3n Estatal, Salud, Infancia y Bienestar Social (CSAI), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Mar\u00eda","family":"Gonzalez-Alba","sequence":"additional","affiliation":[{"name":"Grupo de Investigaci\u00f3n en Microbiolog\u00eda Translacional, Instituto de Investigaci\u00f3n Sanitaria del Principado de Asturias (ISPA), Microbiology Department, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8229-5540","authenticated-orcid":false,"given":"Agust\u00edn","family":"Benito","sequence":"additional","affiliation":[{"name":"Centro Nacional de Medicina Tropical (CNMT), Instituto de Salud Carlos III (ISCIII), 28029 Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Enfermedades Infecciosas (CIBERINFEC), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c1frica","family":"Holgu\u00edn","sequence":"additional","affiliation":[{"name":"HIV-1 Molecular Epidemiology Laboratory, Microbiology and Parasitology Department, Hospital Ram\u00f3n y Cajal-IRYCIS and CIBEREsp-RITIP-CoRISpe, 20834 Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red en Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,21]]},"reference":[{"key":"ref_1","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS) (2022). Danger: UNAIDS Global AIDS Update 2022, Joint United Nations Programme on HIV\/AIDS (UNAIDS). Available online: https:\/\/www.unaids.org\/en\/resources\/documents\/2022\/in-danger-global-aids-update."},{"key":"ref_2","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS) (2022, September 01). AIDSinfo Web. People Living with HIV in Equatorial Guinea. Epidemiological Estimates 2022. Available online: https:\/\/aidsinfo.unaids.org."},{"key":"ref_3","unstructured":"Ministerio de Asuntos Sociales e Igualdad de G\u00e9nero de Guinea Ecuatorial (MINASIG) (2022, September 01). Informe Nacional de Guinea Ecuatorial. Available online: https:\/\/www.unwomen.org\/sites\/default\/files\/Headquarters\/Attachments\/Sections\/CSW\/64\/National-reviews\/Equatorial%20Guinea.pdf."},{"key":"ref_4","unstructured":"Ministerio de Sanidad y Bienestar Social de Guinea Ecuatorial (MINSAB) (2022, September 01). Encuesta Demogr\u00e1fica y de Salud (EDSGE-I). Available online: https:\/\/dhsprogram.com\/pubs\/pdf\/fr271\/fr271.pdf."},{"key":"ref_5","unstructured":"UNICEF (2022, September 01). Situaci\u00f3n Social de los Menores Afectados Por el VIH\/SIDA en Guinea Ecuatorial. Available online: https:\/\/www.unicef.org\/equatorialguinea\/media\/666\/file\/menores-afectados-por-vihsida-portada-web.pdf."},{"key":"ref_6","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS) (2022, September 01). AIDSinfo Web. Global Treatment Cascade. Special Analysis 2022. Available online: https:\/\/aidsinfo.unaids.org."},{"key":"ref_7","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS) (2022, September 01). AIDSinfo Web. Treatment Cascade in West and Central Africa. Epidemiological Estimates 2022. Available online: https:\/\/aidsinfo.unaids.org."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1016\/j.coph.2019.03.003","article-title":"Phylogenies in ART: HIV reservoirs, HIV latency and drug resistance","volume":"48","author":"Bandera","year":"2019","journal-title":"Curr. Opin. Pharmacol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.meegid.2016.08.031","article-title":"HIV-1 drug resistance and resistance testing","volume":"46","author":"Clutter","year":"2016","journal-title":"Infect. Genet. Evol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Bennett, D.E., Camacho, R.J., Otelea, D., Kuritzkes, D.R., Fleury, H., Kiuchi, M., Heneine, W., Kantor, R., Jordan, M.R., and Schapiro, J.M. (2009). Drug resistance mutations for surveillance of transmitted HIV-1 drug-resistance: 2009 update. PLoS ONE, 4.","DOI":"10.1371\/journal.pone.0004724"},{"key":"ref_11","unstructured":"World Health Organization (WHO) (2022, September 01). HIV Drug Resistance Surveillance Guidance. 2015 Update. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/204471."},{"key":"ref_12","unstructured":"World Health Organization (WHO) (2022, September 01). HIV Drug Resistance Report 2021. Technical Report. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240038608."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1080\/09540121.2015.1124976","article-title":"Self-reported adherence to antiretroviral therapy in HIV+ population from Bata, Equatorial Guinea","volume":"28","author":"Herrador","year":"2016","journal-title":"AIDS Care"},{"key":"ref_14","unstructured":"World Health Organization (WHO) (2022, September 01). Updated Recommendations on First-Line and Second-Line Antiretroviral Regimens and Post-Exposure Prophylaxis and Recommendations on Early Infant Diagnosis of HIV: Interim Guidelines; Supplement to the 2016 Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection. Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/277395\/WHO-CDS-HIV-18.51-eng.pdf?sequence=1&isAllowed=y."},{"key":"ref_15","unstructured":"Ministerio de Sanidad y Bienestar Social de Guinea Ecuatorial (MINSAB) (2018). Gu\u00eda Integrada Del uso de Antirretrovirales Para la Prevenci\u00f3n y el Tratamiento de La infecci\u00f3n VIH."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1093\/infdis\/jix089","article-title":"Impact of HIV Drug Resistance on HIV\/AIDS-associated mortality, new infections, and antiretroviral therapy program costs in sub-Saharan Africa","volume":"215","author":"Phillips","year":"2017","journal-title":"J. Infect. Dis."},{"key":"ref_17","unstructured":"World Health Organization (WHO) (2022, September 01). Global Action Plan on HIV Drug Resistance 2017\u20132021. Available online: https:\/\/www.who.int\/publications\/i\/item\/978-92-4-151284-8."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1016\/S1473-3099(11)70141-4","article-title":"HIV-1-resistance-associated mutations after failure of first-line antiretroviral treatment among children in resource-poor regions: A systematic review","volume":"11","author":"Sigaloff","year":"2011","journal-title":"Lancet Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/S1473-3099(18)30647-9","article-title":"Global and regional molecular epidemiology of HIV-1, 1990-2015: A systematic review, global survey, and trend analysis","volume":"19","author":"Hemelaar","year":"2019","journal-title":"Lancet Infect. Dis."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/01.qco.0000200293.45532.68","article-title":"HIV-1 subtypes: Epidemiology and significance for HIV management","volume":"19","author":"Geretti","year":"2006","journal-title":"Curr. Opin. Infect. Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"866705","DOI":"10.3389\/fmicb.2022.866705","article-title":"Genetic diversity and low therapeutic impact of variant-specific markers in HIV-1 pol proteins","volume":"13","author":"Reinosa","year":"2022","journal-title":"Front. Microbiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e00539-19","DOI":"10.1128\/AAC.00539-19","article-title":"An evolutionary model-based approach to quantify the genetic barrier to drug resistance in fast-evolving viruses and its application to HIV-1 subtypes and integrase inhibitors","volume":"63","author":"Theys","year":"2019","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1186\/1758-2652-12-11","article-title":"Differences in resistance mutations among HIV-1 non-subtype B infections: A systematic review of evidence (1996\u20132008)","volume":"12","author":"Pai","year":"2009","journal-title":"J. Int. AIDS Soc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.jcv.2006.05.001","article-title":"Natural polymorphisms in the protease gene modulate the replicative capacity of non-B HIV-1 variants in the absence of drug pressure","volume":"36","author":"Hamy","year":"2006","journal-title":"J. Clin. Virol."},{"key":"ref_25","first-page":"98","article-title":"Efficacy of antiretroviral therapy in individuals infected with HIV-1 non-B subtypes","volume":"8","author":"Rivas","year":"2006","journal-title":"AIDS Rev."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"368","DOI":"10.1016\/j.jinf.2015.05.011","article-title":"HIV-1 variability and viral load technique could lead to false positive HIV-1 detection and to erroneous viral quantification in infected specimens","volume":"71","author":"Alvarez","year":"2015","journal-title":"J. Infect."},{"key":"ref_27","unstructured":"World Health Organization (WHO) (2020). WHO Manual for HIV Drug Resistance Testing Using Dried Blood Spot Specimens, World Health Organization. [3rd ed.]. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789240009424."},{"key":"ref_28","first-page":"100","article-title":"Dried blood spots for monitoring HIV infection in Public Health Programs in developing countries","volume":"31","year":"2013","journal-title":"Enferm. Infecc. Microbiol. Cl\u00edn."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Alvarez, P., Fern\u00e1ndez McPhee, C., Prieto, L., Mart\u00edn, L., Obiang, J., Avedillo, P., Vargas, A., Rojo, P., Benito, A., and Ramos, J.T. (2016). HIV-1 variants and drug resistance in pregnant women from Bata (Equatorial Guinea): 2012-2013. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0165333"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1089\/aid.2010.0046","article-title":"HIV type 1 pol gene diversity and genotypic antiretroviral drug resistance mutations in Malabo, Equatorial Guinea","volume":"26","author":"Djoko","year":"2010","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"851","DOI":"10.1089\/088922201750252043","article-title":"Molecular epidemiology of HIV type 1 subtypes in Equatorial Guinea","volume":"17","author":"Ortiz","year":"2001","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Yebra, G., de Mulder, M., and Holgu\u00edn, A. (2013). Description of HIV-1 group M molecular epidemiology and drug resistance prevalence in Equatorial Guinea from migrants in Spain. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0064293"},{"key":"ref_33","unstructured":"Cepheid (2022, June 13). Xpert\u00ae HIV-1 Qual. Available online: http:\/\/www.cepheid.com\/en\/cepheid-solutions\/clinical-ivd-tests\/virology\/xpert-hiv-1-qual."},{"key":"ref_34","unstructured":"Cepheid (2022, June 13). Xpert\u00ae HIV-1 Viral Load. Available online: http:\/\/www.cepheid.com\/en\/cepheid-solutions\/clinical-ivd-tests\/virology\/xpert-hiv-1-viralload."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"5679","DOI":"10.1038\/s41598-019-41963-y","article-title":"Utility of POC Xpert HIV-1 Tests for detection-quantification of complex HIV recombinants using dried blood spots from Kinshasa, D.R.Congo","volume":"9","author":"Ndarabu","year":"2019","journal-title":"Sci. Rep."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Mwinga, K., Vermund, S.H., Chen, Y.Q., Mwatha, A., Read, J.S., Urassa, W., Carpenetti, N., Valentine, M., and Goldenberg, R.L. (2009). Selected hematologic and biochemical measurements in African HIV-infected and uninfected pregnant women and their infants: The HIV Prevention Trials Network 024 protocol. BMC Pediatr., 9.","DOI":"10.1186\/1471-2431-9-49"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1002\/ajh.20848","article-title":"Hematologic reference values for African American children and adolescents","volume":"82","author":"Robins","year":"2007","journal-title":"Am. J. Hematol."},{"key":"ref_38","unstructured":"Walker, H.K., Hall, W.D., and Hurst, J.W. (1990). Hemoglobin and Hematocrit. Clinical Methods: The History, Physical, and Laboratory Examinations, Butterworths. [3rd ed.]. Chapter 151."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"66","DOI":"10.1016\/j.jcv.2014.12.018","article-title":"HIV-1 infection using dried blood spots can be confirmed by Bio-Rad Geenius\u2122 HIV 1\/2 confirmatory assay","volume":"63","author":"Prieto","year":"2015","journal-title":"J. Clin. Virol."},{"key":"ref_40","unstructured":"France Recherche Nord & Sud Sida-HIV H\u00e9patites (ANRS) (2015). ANRS AC11 Resistance Study Group PCR and Sequencing Procedures: HIV-1, National Agency for AIDS Research."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e523","DOI":"10.1111\/1469-0691.12264","article-title":"Transmitted drug-resistance in human immunodeficiency virus-infected adult population in El Salvador, Central America","volume":"19","author":"Yebra","year":"2013","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Rubio-Garrido, M., Reina, G., Ndarabu, A., Rodriguez-Galet, A., Valad\u00e9s-Alcaraz, A., Barqu\u00edn, D., Carlos, S., and Holgu\u00edn, \u00c1. (2021). High drug resistance levels could compromise the control of HIV infection in paediatric and adolescent population in Kinshasa, the Democratic Republic of Congo. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0248835"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1093\/jac\/dkz417","article-title":"Integrase strand transfer inhibitor (INSTI)-resistance mutations for the surveillance of transmitted HIV-1 drug resistance","volume":"75","author":"Tzou","year":"2020","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"18461","DOI":"10.1038\/s41598-020-74558-z","article-title":"Current and historic HIV-1 molecular epidemiology in paediatric and adult population from Kinshasa in the Democratic Republic of Congo","volume":"10","author":"Reina","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_45","unstructured":"World Health Organization (WHO) (2022, September 01). Guideline on When to Start Antiretroviral Therapy and on Pre-Exposure Prophylaxis for HIV. Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/186275\/9789241509565_eng.pdf."},{"key":"ref_46","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS) (2022, September 01). AIDSinfo. Trend of AIDS-Related Deaths. Epidemilogical Estimates. Available online: https:\/\/aidsinfo.unaids.org\/."},{"key":"ref_47","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS) (2022, September 01). AIDSinfo. Progress towards 95-95-95 Target. Special Analysis. Available online: https:\/\/aidsinfo.unaids.org\/."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.annepidem.2020.08.003","article-title":"Assessing linear CD4 decline quantifying diagnosis delay after HIV seroconversion: Assessing the linearity assumption of CD4 decline","volume":"52","author":"Robertson","year":"2020","journal-title":"Ann. Epidemiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1080\/09540120701439303","article-title":"Late HIV diagnosis and delay in CD4 count measurement among HIV-infected patients in Southern Thailand","volume":"20","author":"Thanawuth","year":"2008","journal-title":"AIDS Care"},{"key":"ref_50","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS) (2022, October 06). AIDSinfo. Treatment Cascade. Late Diagnosis in West and Central African Region. Available online: https:\/\/aidsinfo.unaids.org\/."},{"key":"ref_51","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS) (2022, October 06). AIDSinfo. Vertical Transmission Rate in Equatorial Guinea (Data Sheet). Available online: https:\/\/www.unaids.org\/en\/regionscountries\/countries\/equatorialguinea."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1097\/QAI.0000000000001609","article-title":"Rapid serological test ineffectively screen for HIV exposure in HIV-positive infants","volume":"77","author":"Urick","year":"2018","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_53","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS) (2022, October 06). AIDSinfo. Elimination of Vertical Transmission. Vertical Transmission rate in West and Central Africa (Data Sheet). Available online: https:\/\/aidsinfo.unaids.org\/."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1016\/S0140-6736(04)17140-7","article-title":"Mortality of infected and uninfected infants born to HIV-infected mothers in Africa: A pooled analysis","volume":"364","author":"Newell","year":"2004","journal-title":"Lancet"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1097\/INF.0b013e3181469050","article-title":"Early diagnosis of human immunodeficiency virus in infants using polymerase chain reaction on dried blood spots in Botswana\u2019s national program for prevention of mother-to-child transmission","volume":"27","author":"Creek","year":"2008","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_56","first-page":"566","article-title":"Early diagnosis of human immunodeficiency virus-1 in infants: The prevention of mother-to-child transmission program in Equatorial Guinea","volume":"34","author":"Vargas","year":"2016","journal-title":"Enferm. Infecc. Microbiol. Cl\u00edn."},{"key":"ref_57","unstructured":"(2022, September 01). The Global Alliance to End AIDS in Children by 2030. UNAIDS 2022. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/global-alliance-end-AIDS-in-children_en.pdf."},{"key":"ref_58","unstructured":"Monitoring HIV Impact Using Population-Based Surveys (2022, September 01). UNAIDS\/WHO 2015. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/JC2763_PopulationBasedSurveys_en.pdf."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1645","DOI":"10.1093\/cid\/ciw645","article-title":"Suboptimal Viral Suppression Rates Among HIV-Infected Children in Low- and Middle-Income Countries: A Meta-analysis","volume":"63","author":"Boerma","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1213","DOI":"10.1586\/14787210.2015.1068117","article-title":"Tackling virological failure in HIV-infected children living in Africa","volume":"13","author":"Jenabian","year":"2015","journal-title":"Expert Rev. Anti-Infect. Ther."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1770","DOI":"10.1093\/cid\/cix1104","article-title":"Human Immunodeficiency Virus Antiretroviral Resistance and Transmission in Mother-Infant Pairs Enrolled in a Large Perinatal Study","volume":"66","author":"Yeganeh","year":"2018","journal-title":"Clin. Infect. Dis."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1097\/QAI.0000000000001553","article-title":"High prevalence of HIV drug resistance among newly diagnosed infants aged <18 months: Results from a nationwide surveillance in Nigeria","volume":"77","author":"Inzaule","year":"2018","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1774","DOI":"10.1093\/jac\/dkx025","article-title":"Drug resistance in antiretroviral-na\u00efve children newly diagnosed with HIV-1 in Manaus, Amazonas","volume":"72","author":"Monteiro","year":"2017","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1649","DOI":"10.1007\/s40265-020-01379-9","article-title":"HIV-1 Integrase Inhibitors: A comparative review of efficacy and safety","volume":"80","author":"Scarsi","year":"2020","journal-title":"Drugs"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"2531","DOI":"10.1056\/NEJMoa2108793","article-title":"Dolutegravir as first- or second-line treatment for HIV-1 infection in children","volume":"385","author":"Turkova","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1097\/00002030-200102160-00001","article-title":"Relationship between HIV-1 Env subtypes A and D and disease progression in a rural Ugandan cohort","volume":"15","author":"Kaleebu","year":"2001","journal-title":"Aids"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1016\/j.jcv.2012.01.005","article-title":"Naturally occurring resistance mutations to HIV-1 entry inhibitors in subtypes B, C, and CRF31_BC","volume":"54","author":"Junqueira","year":"2012","journal-title":"J. Clin. Virol."},{"key":"ref_68","unstructured":"Joint United Nations Programme on HIV\/AIDS (UNAIDS) (2022, September 01). Understanding Fast-Track: Accelerating Action to End the AIDS Epidemic by 2030. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/media_asset\/201506_JC2743_Understanding_FastTrack_en.pdf."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/15\/1\/27\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:45:31Z","timestamp":1760147131000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/15\/1\/27"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,21]]},"references-count":68,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["v15010027"],"URL":"https:\/\/doi.org\/10.3390\/v15010027","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,21]]}}}