Drug resistance mutations among antiretroviral-treated female sex workers in Nairobi, Kenya

Abstract

Antiretroviral drug resistance remains an important and a growing challenge in HIV management as it almost always lead to treatment failure. Sex workers face persistent exposures to the different HIV-1 variants and in turn pose a risk of transmission to the general population and measuring drug resistance in this population may serve as a measure for the risk of transmission of these strains to drug naïve populations. The objective of this study was therefore to determine the pattern and prevalence of HIV-1 drug resistance mutations in a cohort of female sex workers in Nairobi, Kenya. Plasma from 60 female sex workers on antiretroviral treatment for over six months was analyzed by amplification and sequencing of the reverse transcriptase - pol region. Five samples (8.3%) showed antiretroviral resistance-associated mutations. One sample (1.7%) showed mutations conferring resistance only to the NNRTI class, 2 samples (3.3%) showed mutations conferring resistance only to the NRTI class while 2 samples (3.3%) showed mutations conferring resistance to both NRTI and NNRTI classes. Phylogenetic analysis revealed HIV-1 subtype A1 (96.7%) and HIV-1 subtype D (3.3%). The prevalence rate of 8.3% for reverse transcriptase-associated resistance mutations was observed. This is a lower rate than has been reported from studies among antiretroviral (ARV)-treated individuals in the country.