TY - JOUR
T1 - Characterization of drug resistance mutations in naïve and ART-treated patients infected with HIV-1 in Yaounde, Cameroon
AU - Ceccarelli, Laura
AU - Salpini, Romina
AU - Moudourou, Sylvie
AU - Cento, Valeria
AU - Santoro, Maria M.
AU - Fokam, Joseph
AU - Takou, Desire
AU - Nanfack, Aubin
AU - Dori, Luca
AU - Torimiro, Judith
AU - Sarmati, Loredana
AU - Andreoni, Massimo
AU - Perno, Carlo F.
AU - Colizzi, Vittorio
AU - Cappelli, Giulia
PY - 2012/5
Y1 - 2012/5
N2 - Currently the prevalence of HIV-1 infection in Cameroon is 5.1%, CRF02-AG subtype is responsible for about 50% of infections. Since an HIV-1 drug resistance test is not yet available widely, accurate data on the prevalence of resistant viral strains are missing. The objective of this study was to determine HIV-1 genetic diversity and to characterize HIV-1 mutations conferring drug resistance among antiretroviral therapy (ART)-naïve and ART-treated patients. A cohort of 239 patients infected with HIV were followed-up between January 2007 and July 2010 in Cameroon. Two hundred and sixteen plasma samples were sequenced for phylogenetic analysis and identification of drug resistance mutations in the HIV-1 pol region. A significant genetic diversity was found: Seven pure subtypes (A1, A3, D, F1, F2, G, H), nine circulating recombinant forms (CRFs: 01-AE, 02-AG, 06cpx, 09cpx, 11cpx, 13cpx, 16cpx, 18cpx, 37cpx) and one new unique recombinant form (URF) (G/F2). The rate of transmitted drug resistance (TDR) in naïve patients was 8.2% (4/49). Around 80% of patients failing a first-line ART harbored a virus with at least one resistance mutation to two antiretroviral (ARV) classes, and 36% of those failing a second-line regimen carried a virus with at least one resistant mutation to three ARV classes. The high level of drug resistance observed in the cohort is alarming because this occurred as a result of only few years of treatment. Adherence to therapy, adequate education of physicians, and the appropriate use of genotypic resistance assay are critical points of intervention for the improvement of patient care.
AB - Currently the prevalence of HIV-1 infection in Cameroon is 5.1%, CRF02-AG subtype is responsible for about 50% of infections. Since an HIV-1 drug resistance test is not yet available widely, accurate data on the prevalence of resistant viral strains are missing. The objective of this study was to determine HIV-1 genetic diversity and to characterize HIV-1 mutations conferring drug resistance among antiretroviral therapy (ART)-naïve and ART-treated patients. A cohort of 239 patients infected with HIV were followed-up between January 2007 and July 2010 in Cameroon. Two hundred and sixteen plasma samples were sequenced for phylogenetic analysis and identification of drug resistance mutations in the HIV-1 pol region. A significant genetic diversity was found: Seven pure subtypes (A1, A3, D, F1, F2, G, H), nine circulating recombinant forms (CRFs: 01-AE, 02-AG, 06cpx, 09cpx, 11cpx, 13cpx, 16cpx, 18cpx, 37cpx) and one new unique recombinant form (URF) (G/F2). The rate of transmitted drug resistance (TDR) in naïve patients was 8.2% (4/49). Around 80% of patients failing a first-line ART harbored a virus with at least one resistance mutation to two antiretroviral (ARV) classes, and 36% of those failing a second-line regimen carried a virus with at least one resistant mutation to three ARV classes. The high level of drug resistance observed in the cohort is alarming because this occurred as a result of only few years of treatment. Adherence to therapy, adequate education of physicians, and the appropriate use of genotypic resistance assay are critical points of intervention for the improvement of patient care.
KW - HIV-1 diversity
KW - Non-B subtypes
KW - Resource-limited settings
KW - Therapeutic failure
KW - Transmitted drug resistance
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U2 - 10.1002/jmv.23244
DO - 10.1002/jmv.23244
M3 - Article
C2 - 22431019
AN - SCOPUS:84858609379
VL - 84
SP - 721
EP - 727
JO - Journal of Medical Virology
JF - Journal of Medical Virology
SN - 0146-6615
IS - 5
ER -