- The study shows the resistance has been growing since 2014, the earliest year the Kenya Medical Research Institute researchers picked for this study.
- The WHO has since 2019 recommended the use of Dolutegravir (DTG) as the preferred first and second-line of treatment for all population groups.
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More than half of HIV-positive babies in Kenya are already resistant to one or more ARVs even before they begin treatment, a new study suggests.
The study shows the resistance has been growing since 2014, the earliest year the Kenya Medical Research Institute researchers picked up samples for this study.
They collected dried blood spots from infants below 18 months through the Kenya Early Infant Diagnosis programme in 2014, 2017 and 2018.
In 2014, 57.9 per cent of the babies had drug-resistant mutations to some of the then commonly used non-nucleoside reverse transcriptase inhibitors class of ARVs.
This dropped to 54.3 per cent in 2017 and rose to 58 per cent in 2018.
“This was as a result of possible maternal exposure to ART (anti-retroviral therapy). Resistance mutation monitoring should be warranted for infants when ART is initiated,” said Kemri researcher Sheila Kageha, who presented the study at the ongoing Kemri Annual Scientific and Health Conference in Nairobi.
The infants had lower resistance to some of the ARVs known as the nucleoside reverse transcriptase inhibitors.
In 2014, 22.8 per cent of the babies had mutations resistant to NRTI. This dropped to 11.4 per cent in 2017 and rose to 14 per cent in 2018.
“Despite most infants accessing early HIV-1 diagnosis in Kenya, data remains limited on trends of drug-resistant mutations among them,” Kageha said.
She called for effective prevention of mother to child transmission of HIV.
The rates are not alarming and have been reported almost uniformly across many other countries.
According to the World Health Organisation’s report on HIV drug resistance 2021, nearly one-half of infants born to mothers infected with HIV has HIV drug resistance to one or more NNRTIs.
The WHO has since 2019 recommended the use of Dolutegravir as the preferred first and second-line of treatment for all population groups.
Dolutegravir is more effective, easier to take, and has fewer side effects than other drugs currently in use.
The “Guidelines on Use of Antiretroviral Drugs for Treating and Preventing HIV Infection in Kenya” also recommend that children receive Dolutegravir for HIV treatment.
However, despite this guideline, an affordable DTG has been unavailable to children under 20kg so far because of a lack of dispersible tablets that are considered age-appropriate formulations.
Last December, Kenya’s Ministry of Health said it would be available from January in the form of a pill that is dispersible in water and is easily tolerated by children.
About 106,807 Kenyan children below 14 years are living with HIV, but only 72,968 are on treatment.
“This announcement marks a dramatic shift for the quality of HIV treatment for children. Kenya intends to be a first-adopter of the new paediatric DTG 10mg formulation, which will improve treatment, reduce unpleasant side effects, and help children adhere to their treatment and live healthy lives,” Health Mutahi Kagwe said.
-Edited by SKanyara