{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:18:05Z","timestamp":1760235485335,"version":"build-2065373602"},"reference-count":45,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T00:00:00Z","timestamp":1629936000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Roe Green Travel Medicine Award, University Hospitals Cleveland Medical Center","award":["Award Number J0628"],"award-info":[{"award-number":["Award Number J0628"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Genes"],"abstract":"<jats:p>Human immunodeficiency virus (HIV) drug resistance (HIVDR) is widespread in sub-Saharan Africa. Children and pregnant women are particularly vulnerable, and laboratory testing capacity remains limited. We, therefore, used a cross-sectional design and convenience sampling to characterize HIV subtypes and resistance-associated mutations (RAMs) in these groups in Sierra Leone. In total, 96 children (age 2\u20139 years, 100% ART-experienced), 47 adolescents (age 10\u201318 years, 100% ART-experienced), and 54 pregnant women (&gt;18 years, 72% ART-experienced) were enrolled. Median treatment durations were 36, 84, and 3 months, respectively, while the sequencing success rates were 45%, 70%, and 59%, respectively, among children, adolescents, and pregnant women. Overall, the predominant HIV-1 subtype was CRF02_AG (87.9%, 95\/108), with minority variants constituting 12%. Among children and adolescents, the most common RAMs were M184V (76.6%, n = 49\/64), K103N (45.3%, n = 29\/64), Y181C\/V\/I (28.1%, n = 18\/64), T215F\/Y (25.0%, n = 16\/64), and V108I (18.8%, n = 12\/64). Among pregnant women, the most frequent RAMs were K103N (20.6%, n = 7\/34), M184V (11.8%, n = 4\/34), Y181C\/V\/I (5.9%, n = 2\/34), P225H (8.8%, n = 3\/34), and K219N\/E\/Q\/R (5.9%, n = 2\/34). Protease and integrase inhibitor-RAMs were relatively few or absent. Based on the genotype susceptibility score distributions, 73%, 88%, and 14% of children, adolescents, and pregnant women, respectively, were not susceptible to all three drug components of the WHO preferred first-line regimens per 2018 guidelines. These findings suggest that routine HIVDR surveillance and access to better ART choices may improve treatment outcomes in Sierra Leone.<\/jats:p>","DOI":"10.3390\/genes12091314","type":"journal-article","created":{"date-parts":[[2021,8,26]],"date-time":"2021-08-26T05:41:50Z","timestamp":1629956510000},"page":"1314","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Characterizing HIV-1 Genetic Subtypes and Drug Resistance Mutations among Children, Adolescents and Pregnant Women in Sierra Leone"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8474-1812","authenticated-orcid":false,"given":"George A.","family":"Yendewa","sequence":"first","affiliation":[{"name":"Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA"},{"name":"Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA"},{"name":"Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7639-0004","authenticated-orcid":false,"given":"Sulaiman","family":"Lakoh","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone"},{"name":"Ministry of Health and Sanitation, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone"}]},{"given":"Sahr A.","family":"Yendewa","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone"},{"name":"Ministry of Health and Sanitation, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone"}]},{"given":"Khadijah","family":"Bangura","sequence":"additional","affiliation":[{"name":"Ministry of Health and Sanitation, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone"}]},{"given":"Andr\u00e9s","family":"Tabernilla","sequence":"additional","affiliation":[{"name":"Group of Virology and Pathogenesis, Galicia Sur Health Research Institute (IIS Galicia Sur), Complexo Hospitalario Universitario de Vigo, SERGAS-UVigo, 36213 Vigo, Spain"}]},{"given":"Lucia","family":"Pati\u00f1o","sequence":"additional","affiliation":[{"name":"Group of Virology and Pathogenesis, Galicia Sur Health Research Institute (IIS Galicia Sur), Complexo Hospitalario Universitario de Vigo, SERGAS-UVigo, 36213 Vigo, Spain"}]},{"given":"Darlinda F.","family":"Jiba","sequence":"additional","affiliation":[{"name":"Ministry of Health and Sanitation, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3004-2052","authenticated-orcid":false,"given":"Alren O.","family":"Vandy","sequence":"additional","affiliation":[{"name":"Ministry of Health and Sanitation, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone"}]},{"given":"Samuel P.","family":"Massaquoi","sequence":"additional","affiliation":[{"name":"Ministry of Health and Sanitation, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0949-5399","authenticated-orcid":false,"given":"Nuno S.","family":"Os\u00f3rio","sequence":"additional","affiliation":[{"name":"Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal"}]},{"given":"Gibrilla F.","family":"Deen","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone"},{"name":"Ministry of Health and Sanitation, University of Sierra Leone Teaching Hospitals Complex, Freetown, Sierra Leone"}]},{"given":"Foday","family":"Sahr","sequence":"additional","affiliation":[{"name":"Department of Medicine, College of Medicine and Allied Health Sciences, University of Sierra Leone, Freetown, Sierra Leone"}]},{"given":"Robert A.","family":"Salata","sequence":"additional","affiliation":[{"name":"Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA"},{"name":"Division of Infectious Diseases and HIV Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH 44106, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4835-9875","authenticated-orcid":false,"given":"Eva","family":"Poveda","sequence":"additional","affiliation":[{"name":"Group of Virology and Pathogenesis, Galicia Sur Health Research Institute (IIS Galicia Sur), Complexo Hospitalario Universitario de Vigo, SERGAS-UVigo, 36213 Vigo, Spain"}]}],"member":"1968","published-online":{"date-parts":[[2021,8,26]]},"reference":[{"key":"ref_1","unstructured":"WHO (2021, June 22). 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