Emergence of resistance to dolutegravir in children in Senegal: A report on the first two cases in the Thies region

Fatou Sene; Malick Fall; Abdoul Magib Cissé; Oumar Diop; Anna Ndong; Adjaratou Aissatou Ba; Mbengue Fall; Sokhna Niang; Amady Sy; Adja Fatou Mbodji; Aminata Diop; Moussa Camara; Halimatou Diop-Ndiaye

doi:10.53730/ijhs.v10n2.16008

Authors

Fatou Sene
fatoukinesene3@gmail.com
Cheikh Anta Diop University, Dakar, Senegal
Malick Fall Cheikh Anta Diop University, Dakar, Senegal
Abdoul Magib Cissé Department of pediatrics, Mbour Hospital, Mbour, Senegal
Oumar Diop
Anna Ndong Cheikh Anta Diop University, Dakar, Senegal
Adjaratou Aissatou Ba HIV Reference Laboratory in Senegal, Dakar, Senegal
Mbengue Fall HIV Reference Laboratory in Senegal, Dakar, Senegal
Sokhna Niang HIV Reference Laboratory in Senegal, Dakar, Senegal
Amady Sy Laboratory at the El Hadji Amadou Sakhir Ndieguene Regional Hospital in Thiès, Thiès, Senegal
Adja Fatou Mbodji Laboratory at the El Hadji Amadou Sakhir Ndieguene Regional Hospital in Thiès, Thiès, Senegal
Aminata Diop Laboratory at the El Hadji Amadou Sakhir Ndieguene Regional Hospital in Thiès, Thiès, Senegal
Moussa Camara Cheikh Anta Diop University, Dakar, Senegal
Halimatou Diop-Ndiaye HIV Reference Laboratory in Senegal, Dakar, Senegal

Keywords:

Adolescents, DTG resistance, HIV, Thiès, Viral load

Abstract

In Senegal, despite the widespread implementation of pediatric antiretroviral therapy (ART), biological outcomes among children and adolescents remain suboptimal. The objective of this study was to evaluate biological monitoring and determine the antiretroviral drug resistance profile among children and adolescents receiving routine HIV care in the Thies region. This was a descriptive and analytical cross-sectional cohort study from January 2021 to December 2023 including children and adolescents aged 0–19 years, living with HIV, who had been receiving ART for at least six months, were regularly followed up, and had undergone three viral load assessments at months 12, 24, and 36. Genotypic resistance testing was performed in 18 children/adolescents. Cases of dolutegravir (DTG) resistance were identified in two HIV-infected adolescents in Senegal. In Case 1, mutations were identified at eleven positions, five of which were associated with drug resistance: E138K, G118R, M184V, M41L, and T215Y. In Case 2, mutations were detected at eleven positions, seven of which were associated with resistance: E138K, G140A, S147G, Q148R, M184V, T215F, and M41L. Although dolutegravir has demonstrated a high genetic barrier to resistance, routine and large-scale surveillance of primary resistance should be implemented to ensure the long-term effectiveness of DTG-based regimens.

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References

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