Characterization of drug resistance mutations in naïve and ART-treated patients infected with HIV-1 in Yaounde, Cameroon

Laura Ceccarelli, Romina Salpini, Sylvie Moudourou, Valeria Cento, Maria M. Santoro, Joseph Fokam, Desire Takou, Aubin Nanfack, Luca Dori, Judith Torimiro, Loredana Sarmati, Massimo Andreoni, Carlo F. Perno, Vittorio Colizzi, Giulia Cappelli

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)721-727
Number of pages7
JournalJournal of Medical Virology
Volume84
Issue number5
DOIs
Publication statusPublished - May 2012

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Cameroon
Drug Resistance
HIV-1
Mutation
Viruses
Therapeutics
HIV Infections
Patient Care
HIV
Physicians
Education
Infection

Keywords

  • HIV-1 diversity
  • Non-B subtypes
  • Resource-limited settings
  • Therapeutic failure
  • Transmitted drug resistance

ASJC Scopus subject areas

  • Virology
  • Infectious Diseases

Cite this

Ceccarelli, L., Salpini, R., Moudourou, S., Cento, V., Santoro, M. M., Fokam, J., ... Cappelli, G. (2012). Characterization of drug resistance mutations in naïve and ART-treated patients infected with HIV-1 in Yaounde, Cameroon. Journal of Medical Virology, 84(5), 721-727. https://doi.org/10.1002/jmv.23244

Characterization of drug resistance mutations in naïve and ART-treated patients infected with HIV-1 in Yaounde, Cameroon. / Ceccarelli, Laura; Salpini, Romina; Moudourou, Sylvie; Cento, Valeria; Santoro, Maria M.; Fokam, Joseph; Takou, Desire; Nanfack, Aubin; Dori, Luca; Torimiro, Judith; Sarmati, Loredana; Andreoni, Massimo; Perno, Carlo F.; Colizzi, Vittorio; Cappelli, Giulia.

In: Journal of Medical Virology, Vol. 84, No. 5, 05.2012, p. 721-727.

Research output: Contribution to journalArticle

Ceccarelli, L, Salpini, R, Moudourou, S, Cento, V, Santoro, MM, Fokam, J, Takou, D, Nanfack, A, Dori, L, Torimiro, J, Sarmati, L, Andreoni, M, Perno, CF, Colizzi, V & Cappelli, G 2012, 'Characterization of drug resistance mutations in naïve and ART-treated patients infected with HIV-1 in Yaounde, Cameroon', Journal of Medical Virology, vol. 84, no. 5, pp. 721-727. https://doi.org/10.1002/jmv.23244
Ceccarelli, Laura ; Salpini, Romina ; Moudourou, Sylvie ; Cento, Valeria ; Santoro, Maria M. ; Fokam, Joseph ; Takou, Desire ; Nanfack, Aubin ; Dori, Luca ; Torimiro, Judith ; Sarmati, Loredana ; Andreoni, Massimo ; Perno, Carlo F. ; Colizzi, Vittorio ; Cappelli, Giulia. / Characterization of drug resistance mutations in naïve and ART-treated patients infected with HIV-1 in Yaounde, Cameroon. In: Journal of Medical Virology. 2012 ; Vol. 84, No. 5. pp. 721-727.
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abstract = "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)-na{\"i}ve 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 na{\"i}ve 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.",
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