HIV-1 genetic diversity and antiretroviral drug resistance mutations in Peruvian pediatric population.
The HIV/AIDS epidemic remains a major global public health challenge, and the emergence of drug resistance mutations compromises treatment efficacy. The aim of this study was to characterize HIV-1 genetic diversity and antiretroviral drug resistance mutations circulating in Peruvian infants under 18 months of age. A descriptive cross-sectional study was conducted using 28 samples collected between 2017 and 2018. Genetic material was obtained from whole blood (proviral DNA) and plasma (viral RNA), and then analyzed using nested PCR amplification and next-generation sequencing (NGS). HIV-1 subtypes were determined through a phylogenetic analysis, and resistance mutations were identified using the HYDRA and Stanford HIVdb platforms. Subtype B was the most prevalent (89%), followed by circulating recombinant forms CRF17_BF and CRF89_BF (11%). Four out of 28 samples (14.3%) harbored at least one resistance-associated mutation. The most frequently detected mutations included K103N (7.1%), V106I (3.6%), V179E (7.1%), and G190A (3.6%), with 21.4% of the identified mutations associated with non-nucleoside reverse transcriptase inhibitors (NNRTIs). Notably, this study reports the first detection of CRF89_BF in Peruvian infants under 18 months of age. These findings highlight the importance of ongoing molecular surveillance of HIV-1 diversity and antiretroviral resistance mutations to optimize treatment strategies and strengthen HIV control programs.