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Miri L, Ouladlahsen A, Kettani A, Bensghir R, Marhoum Elfilali K, Wakrim L. Characterization of protease resistance-associated mutations in HIV type 1 drug-naive patients following the increasing prevalence of the CRF02_AG strain in Morocco. AIDS Res Hum Retroviruses 2012; 28:571-7. [PMID: 22145994 DOI: 10.1089/aid.2011.0225] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to investigate the amino acid substitutions in the protease of HIV-1 B and non-B subtypes and evaluate whether the emergence of resistance-associated mutations (RAMs) could have a significant correlation with the increasing prevalence of CRF02_AG strains in Morocco. A total of 162 protease gene sequences were successfully amplified from drug-naive HIV-1-infected individuals. We identified eight (sub)subtypes and CRFs: B(66%), A1(3.7%), C(1.2%), F1(0.6%), F2(0.6%), G(1.2%), CRF02_AG(25.3%), and CRF01_AE(1.2%). Phylogenetic analysis of CRF02_AG strains showed that 9.8% of isolates had a closer connection with reference strains from Morocco and 15.4% clustered with reference strains from eight West African and three European countries. When compared to the B subtype, patients with the CRF02_AG strain had a significantly higher prevalence of mutations associated with resistance to some antiprotease drugs, mainly tipranavir (TPV): H69K (97% vs. 5%; p<0.0001), L89M (95% vs. 1%; p<0.0001), and M36I/L (93% vs. 44%; p<0.0001). Most of the CRF02_AG strains (97%) significantly showed at least two TPV-RAMs (p=0.002) compared to the B subtype (7%). Multivariate analysis revealed that CRF02_AG infection was the only factor highly associated with the occurrence of more than two TPV-RAMs (C=0.42; p<0.0001). These results support the importance of transmitted drug resistance mutations (M36I/L, H69K, and L89M) in the protease gene of HIV-1 CRF02_AG isolates. This HIV drug resistance transmission before protease inhibitor (PI) exposure raises concern about its influence on the susceptibility of CRF02_AG strains to some PIs, especially tipranavir, which will soon be introduced as part of the second line therapeutic regimens in Morocco.
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Affiliation(s)
- Lamia Miri
- Laboratoire de Virologie, Institut Pasteur du Maroc, Casablanca, Morocco
| | - Ahd Ouladlahsen
- Service des Maladies Infectieuses, CHU Ibn Rochd, Casablanca, Morocco
| | - Anass Kettani
- Laboratoire de Recherche sur les Lipoprotéines et l'Athérosclérose, Faculté des Sciences Ben M'sik, Casablanca, Morocco
| | - Rajaa Bensghir
- Service des Maladies Infectieuses, CHU Ibn Rochd, Casablanca, Morocco
| | | | - Lahcen Wakrim
- Laboratoire de Virologie, Institut Pasteur du Maroc, Casablanca, Morocco
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Kagone TS, Hien H, Meda N, Diagbouga PS, Sawadogo A, Drabo J, Peeters M, Vergne L, Delaporte E, De Souza C, Gbeassor M, Simpore J. Characterization of HIV-1 genotypes and antiretroviral drug-resistance mutations among patients in Burkina Faso. Pak J Biol Sci 2011; 14:392-8. [PMID: 21902063 DOI: 10.3923/pjbs.2011.392.398] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purposes of this study were: (1) to describe the genetic variability of HIV strains found in Burkina Faso, (2) to characterize non-B HIV strains mutation profiles selected by ARVs and (3) to detect possible resistances induced by ARV drugs. From 30 October 2002 to 20 November 2003, 132 HIV 1-positive patients taking Highly Active Antiretroviral Therapy (HAART) for more than one year in Bobo-Dioulasso and Ouagadougou were included. T-CD4+ lymphocytes count was done using Dynabeads technique while genotypic test and ARV-resistance tests were conducted using Pol sequencing that codes for reverse transcriptase reverse, integrase and protease. Due to undetectable viremia, 86 samples out of 132 could not be characterized. Whereas in the 46 others that had a viral load exceeding 1000 copies mL(-1), the following HIV-1 subtypes were identified: CRF06 (54,55%); CRF02(38,63%); CRF01 (4,55%) and subtype A (2,27%). In addition, several mutations related to PI, NRTI and NNRTI resistance were isolated in 27 samples. This study found a huge genetic HIV-1 polymorphism in Burkina Faso. The level of acquired resistance to ARV after one year of treatment amounted 20.4%. These results clearly show that there is imperative need to set up an ARV resistance surveillance network in Burkina Faso to guide treatment strategies and follow the extension of the phenomenon in the country.
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Affiliation(s)
- T S Kagone
- Centre MURAZ Bobo-Dioulasso, Burkina Faso
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Haidara A, Chamberland A, Sylla M, Aboubacrine SA, Cissé M, Traore HA, Maiga MY, Tounkara A, Nguyen VK, Tremblay C. High level of primary drug resistance in Mali. HIV Med 2010; 11:404-11. [PMID: 20146734 DOI: 10.1111/j.1468-1293.2009.00806.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND As access to antiretroviral drugs increases in developing countries, it will become increasingly important to monitor the emergence of resistance and to define the molecular pathways involved to identify optimal therapeutic regimens. METHODS We performed genotypic resistance testing on plasma obtained from 101 HIV-infected treatment-naïve individuals from Mali. Genotyping was carried out using the Virco protocols and HXB2 was used as the reference strain. RESULTS CRF02_AG was the most common subtype, present in 71.3% of our patient population. Other subtypes included B, C, G, CRF06_CPX, CRF09_CPX, CRF01_AE, A2/CRF16_A2D, A1 and CRF13_CPX. A total of 9.9% [95% confidence interval (CI) 6.9-12.9%] of patients had at least one resistance mutation. The prevalences of mutations conferring resistance to nucleoside reverse transcriptase inhibitors (NRTIs), nonnucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs) were 5% (95% CI 0.7-9.2%), 6% (95% CI 1.3-10.6%) and 0%, respectively. The most frequent mutations were T215A/Y for NRTIs and K103N/T for NNRTIs. One patient harboured three NRTI resistance mutations and one NNRTI mutation. This is the first reported case of multi-drug-resistant viral transmission in Mali. Polymorphisms at protease codons 10I/V and 33F potentially associated with resistance were observed in 18.8% and 1% of patients, respectively. Several polymorphisms in the C-terminal domain of reverse transcriptase were observed: A371V (in 63.4% of patients), G335D (76.2%), E399D (10.9%) and G333E (1%). CONCLUSION Primary resistance was seen in 9.9% of subjects, which is higher than previously reported in Mali. Taking into consideration other polymorphisms in protease such as L10I/V and 33F, primary resistance could reach 28.7% (95% CI 19.9-37.5%). Our study reflects the need to monitor the evolution of resistance on a regular basis and trends of transmitted resistance.
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Affiliation(s)
- A Haidara
- Département de Microbiologie et Immunologie, Université de Montréal, Montréal, Canada
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Tebit DM, Sangaré L, Tiba F, Saydou Y, Makamtse A, Somlare H, Bado G, Kouldiaty BG, Zabsonre I, Yameogo SL, Sathiandee K, Drabo JY, Kräusslich HG. Analysis of the diversity of the HIV-1 pol gene and drug resistance associated changes among drug-naïve patients in Burkina Faso. J Med Virol 2009; 81:1691-701. [PMID: 19697403 DOI: 10.1002/jmv.21600] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A cross-sectional study was undertaken among drug-naïve HIV patients at the University Hospital in Ouagadougou shortly before and after the introduction of large-scale antiretroviral therapy (ART) in Burkina Faso. Baseline clinical and virological data as well as protease (PR) and 5' reverse transcriptase (RT) sequences from 104 HIV infected patients were analyzed. Genotypic classification revealed the following subtypes and recombinant forms: CRF06_cpx, n = 46 (44.2%); CRF02_AG, n = 39 (37.5%); subtype A, n = 4 (3.8%); CRF09_cpx, n = 2 (1.9%); and unclassified, n = 13 (12.5%). Bootstrap analysis of CRF02_AG and CRF06_cpx viruses showed that >80% had a similar structure to their respective prototypes. The prevalence of primary drug resistance mutations was 12.5%, all mutations arising in the RT sequences in accordance with the dominance of this drug class in Burkina Faso. The mutations were distributed as follows: NRTI (10.6%): M41L (n = 2), D67N (n = 2), K70K/E (n = 2), L210W (n = 1), T215S/Y (n = 2), and K219K/Q (n = 2); NNRTI (6.1%): K103K/N (n = 2), Y181C (n = 2), G190G/A (n = 1), and P236P/L (n = 1). Subtype specific secondary polymorphisms such as K20I and M36I in the PR were observed in almost all patients. Drug resistance mutations occurred at similar frequencies (12.8% and 10.8%, respectively) among patients infected with CRF02_AG and CRF06_cpx. Some subtype specific polymorphisms were observed within important HLA epitopes, including B35, B7, and A2 in the RT, and A*6802 in the PR sequences. The observed resistance mutations are most likely to have been transmitted based on the timing of the study but prior undocumented use of ART cannot be excluded.
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Affiliation(s)
- Denis M Tebit
- Abteilung Virologie, Universitaetsklinikum Heidelberg, Heidelberg, Germany
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Chan PA, Kantor R. Transmitted drug resistance in nonsubtype B HIV-1 infection. ACTA ACUST UNITED AC 2009; 3:447-465. [PMID: 20161523 DOI: 10.2217/hiv.09.30] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
HIV-1 nonsubtype B variants account for the majority of HIV infections worldwide. Drug resistance in individuals who have never undergone antiretroviral therapy can lead to early failure and limited treatment options and, therefore, is an important concern. Evaluation of reported transmitted drug resistance (TDR) is challenging owing to varying definitions and study designs, and is further complicated by HIV-1 subtype diversity. In this article, we discuss the importance of various mutation lists for TDR definition, summarize TDR in nonsubtype B HIV-1 and highlight TDR reporting and interpreting challenges in the context of HIV-1 diversity. When examined carefully, TDR in HIV-1 non-B protease and reverse transcriptase is still relatively low in most regions. Whether it will increase with time and therapy access, as observed in subtype-B-predominant regions, remains to be determined.
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Mintsa-Ndong A, Caron M, Plantier JC, Makuwa M, Le Hello S, Courgnaud V, Roques P, Kazanji M. High HIV Type 1 prevalence and wide genetic diversity with dominance of recombinant strains but low level of antiretroviral drug-resistance mutations in untreated patients in northeast Gabon, Central Africa. AIDS Res Hum Retroviruses 2009; 25:411-8. [PMID: 19320567 DOI: 10.1089/aid.2008.0223] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The northeast of Gabon, central Africa is characterized by high population density and a high rate of immigration from the surrounding countries. To determine the prevalence, circulating subtypes, and antiretroviral resistance mutations of HIV-1, 810 blood samples were collected from the general population of the two main cities (Oyem and Makokou) of this region. Of these, 61 (7.5%) were found to be positive for HIV-1. Analysis of the env (gp120), pol, and gag (p24) sequences as well as phylogenetic analyses showed at least eight different viral lineages. The most prevalent strains were CRF02 recombinants, followed by subtypes A, D, and C. The remaining strains were found to be F, J, G, and also, for the first time in Gabon, the recombinant form CRF11cpx. Analysis of antiretroviral drug-resistance mutations in protease and reverse transcriptase from this untreated population showed a low level of specific mutations. These mutations were associated with subtype polymorphism rather than with resistance to antiretroviral drugs. The wide diversity and the emergence of recombinant strains are in accordance with the rapid spread of new HIV strains in the population and, thus, the dynamic evolution of the epidemic.
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Affiliation(s)
- Armel Mintsa-Ndong
- Unité de Rétrovirologie, Centre International de Recherches Médicales de Franceville, Franceville, Gabon
| | - Melanie Caron
- Unité de Rétrovirologie, Centre International de Recherches Médicales de Franceville, Franceville, Gabon
- Service de Coopération et d'Action Culturelle, French Embassy, Libreville, Gabon
| | | | - Maria Makuwa
- Unité de Rétrovirologie, Centre International de Recherches Médicales de Franceville, Franceville, Gabon
| | - Simon Le Hello
- Unité de Rétrovirologie, Centre International de Recherches Médicales de Franceville, Franceville, Gabon
| | - Valerie Courgnaud
- Institut de Génétique Moléculaire CNRS Unité Mixte de Recherches 5535, Université Montpellier II, Montpellier, France
| | - Pierre Roques
- Unité de Rétrovirologie, Centre International de Recherches Médicales de Franceville, Franceville, Gabon
- Service de Coopération et d'Action Culturelle, French Embassy, Libreville, Gabon
- Service d'Immuno-virologie, Unité Mixte de Recherches E1, Pais XI, Centre d'Etudes Nucleaires, Fontenay aux Roses, France
| | - Mirdad Kazanji
- Unité de Rétrovirologie, Centre International de Recherches Médicales de Franceville, Franceville, Gabon
- Service de Coopération et d'Action Culturelle, French Embassy, Libreville, Gabon
- Réseau International des Instituts Pasteur, Institut Pasteur, Paris, France
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Caron M, Makuwa M, Souquière S, Descamps D, Brun-Vézinet F, Kazanji M. Human immunodeficiency virus type 1 seroprevalence and antiretroviral drug resistance-associated mutations in miners in Gabon, central Africa. AIDS Res Hum Retroviruses 2008; 24:1225-8. [PMID: 18788914 DOI: 10.1089/aid.2008.0097] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Miners in sub-Saharan African are known to have an extremely high prevalence of HIV-1 infection. We therefore evaluated the prevalence of HIV-1 infection among manganese miners in Gabon, central Africa and examined the diversity of HIV-1 strains by characterizing the polymorphism of the pol gene in order to observe drug resistance-associated mutations. In 857 samples tested, the HIV-1 prevalence was 2.9%. By pol sequence analysis, we showed that all the HIV-1 strains belonged to group M, with a majority of CRF02_AG (57%) followed by subtype A (9%) and CRF01_AE or subtype B (4%). The remaining HIV-1 strains demonstrated discordant genomic results and exhibited a mosaic pol genome (30%). Most of the mutations detected in pol coding regions corresponded to the subtype polymorphism, with no specific antiretroviral drug resistance. To avoid the rapid emergence of resistant viruses in this part of central Africa, continuous surveillance of the circulation of drug-resistant viruses must be maintained to guide treatment strategies.
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Affiliation(s)
- Mélanie Caron
- Unité de Rétrovirologie, Centre International de Recherches Médicales, Franceville,Gabon
| | - Maria Makuwa
- Unité de Rétrovirologie, Centre International de Recherches Médicales, Franceville,Gabon
| | - Sandrine Souquière
- Unité de Rétrovirologie, Centre International de Recherches Médicales, Franceville,Gabon
| | - Diane Descamps
- Service de Virologie, Centre Hospitalier Bichat-Claude Bernard, Paris, France
| | | | - Mirdad Kazanji
- Unité de Rétrovirologie, Centre International de Recherches Médicales, Franceville,Gabon
- Service de Coopération et d'Action Culturelle, French Embassy, Libreville, Gabon
- Réseau International des Instituts Pasteur, Institut Pasteur, 75015 Paris, France
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Messou E, Gabillard D, Moh R, Inwoley A, Sorho S, Eholié S, Rouet F, Seyler C, Danel C, Anglaret X. Anthropometric and immunological success of antiretroviral therapy and prediction of virological success in west African adults. Bull World Health Organ 2008; 86:435-42. [PMID: 18568272 DOI: 10.2471/blt.07.042911] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2007] [Accepted: 11/07/2007] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The 6 month assessment of the response to antiretroviral therapy (ART) is a critical step. In sub-Saharan Africa, few people have access to plasma viral-load measurement. We assessed the gain or loss in body mass index (BMI), alone or in combination with the gain or loss in CD4+ T-cell count (CD4), as a tool for predicting the response to ART. METHODS In a cohort of 622 adults in Abidjan, Côte d'Ivoire, we calculated the sensitivity, specificity and predictive values of BMI and CD4 for treatment success defined as viral-load undetectability (< 300 copies/ml) as gold standard. FINDINGS After 6 months of ART, the median change in BMI was an increase of 1.0 kg/m(2) (interquartile range, IQR: 0.0-2.1), the median change in CD4 an increase of 148/ml (IQR: 54-230) and 84% of patients reached viral-load undetectability. The distribution of change in BMI was similar among patients who reached undetectability and those who did not (increases of 1.06 kg/m(2) versus 0.99 kg/m(2), P = 0.51). With larger changes in BMI, the specificity for treatment success increased but its sensitivity decreased and its positive predictive value was stable around 85%. All results remained similar when combining changes in BMI with those in CD4 and when stratifying by groups of baseline BMI or CD4. CONCLUSION In settings where viral-load measurement is not available, a high BMI gain does not reflect virological success, even when combined with a high CD4 gain. In our population, most patients with detectable viral-load had probably adhered to the drug regimen sufficiently to reach significant gains in body mass and CD4 count but had adhered insufficiently to reach viral suppression.
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HIV-1 DNA in Peripheral Blood Mononuclear Cells Is Strongly Associated With HIV-1 Disease Progression in Recently Infected West African Adults. J Acquir Immune Defic Syndr 2008; 27:627-9. [PMID: 18580249 DOI: 10.1097/qai.0b013e3181775e55] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Hamers RL, Derdelinckx I, van Vugt M, Stevens W, Rinke de Wit TF, Schuurman R. The Status of HIV-1 Resistance to Antiretroviral drugs in Sub-Saharan Africa. Antivir Ther 2008. [DOI: 10.1177/135965350801300502] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Access to highly active antiretroviral therapy (HAART) for persons infected with HIV in sub-Saharan Africa has greatly improved over the past few years. However, data on long-term clinical outcomes of Africans receiving HAART, patterns of HIV resistance to antiretroviral drugs and implications of HIV type-1 (HIV-1) subtype diversity in Africa for resistance, are limited. In resource-limited settings, concerns have been raised that deficiencies in health systems could create the conditions for accelerated development of resistance. Coordinated surveillance systems are being established to assess the emergence of resistance and the factors associated with resistance development, and to create the possibility for adjusting treatment guidelines as necessary. The purpose of this report is to review the literature on HIV-1 resistance to antiretroviral drugs in sub-Saharan Africa, in relation to the drug regimens used in Africa, HIV-1 subtype diversity and overall prevalence of resistance. The report focuses on resistance associated with treatment, prevention of mother-to-child transmission and transmitted resistance. It also outlines priorities for public health action and research.
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Affiliation(s)
- Raph L Hamers
- PharmAccess Foundation, Center for Poverty-Related Communicable Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Inge Derdelinckx
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Michèle van Vugt
- PharmAccess Foundation, Center for Poverty-Related Communicable Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Division of Infectious Diseases, Tropical Medicine and AIDS, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Wendy Stevens
- Department of Molecular Medicine and Haematology, University of the Witwatersrand, Johannesburg, South Africa
| | - Tobias F Rinke de Wit
- PharmAccess Foundation, Center for Poverty-Related Communicable Diseases, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Rob Schuurman
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands
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Derache A, Maiga AI, Traore O, Akonde A, Cisse M, Jarrousse B, Koita V, Diarra B, Carcelain G, Barin F, Pizzocolo C, Pizarro L, Katlama C, Calvez V, Marcelin AG. Evolution of genetic diversity and drug resistance mutations in HIV-1 among untreated patients from Mali between 2005 and 2006. J Antimicrob Chemother 2008; 62:456-63. [PMID: 18556706 DOI: 10.1093/jac/dkn234] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To describe HIV-1 variants circulating in Mali and to estimate the rate of transmission of HIV-1 drug resistance in 2006. PATIENTS AND METHODS Viral reverse transcriptase (RT) and protease (PR) genes from 198 antiretroviral (ARV)-naive patients diagnosed HIV-1 positive in May 2006 in Bamako and Segou were sequenced. RESULTS Although CRF02_AG was always the predominant HIV-1 subtype observed (72%), a higher genetic diversity than that in 2005 was observed. The overall prevalence of primary resistance is 11.5% in Mali in 2006, according to the 2007 IAS-USA list of mutations [nucleoside RT inhibitor (NRTI): 1.5%, non-NRTI (NNRTI): 9% and PI: 1%], and 2.5% (NRTI: 1%, NNRTI: 1.5% and PI: 0%), according to the Stanford list of mutations. There was no significant difference between 2005 and 2006 in the overall primary resistance prevalence or in the prevalence of mutations in the different ARV classes. Resistance mutations found in RT and PR genes are in agreement with the highly active antiretroviral therapy regimen available in Mali, except for V90I, V106I and A98G mutations which are associated with etravirine resistance, but polymorphic in non-B subtypes. CONCLUSIONS HIV-1 genetic diversity seems increased in Mali, but the overall HIV-1 primary resistance prevalence remains low. This is consistent with the findings from other West African countries where prevalence rates are lower than 5%. However, considering the large scaling up of ARV use in this country, it is necessary to regularly monitor the development of primary resistance in Mali.
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Affiliation(s)
- Anne Derache
- UPMC Univ Paris 06, EA2387, 4 Place Jussieu, F-75005 Paris, France
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Toni TD, Masquelier B, Minga A, Anglaret X, Danel C, Coulibaly A, Chenal H, Dabis F, Salamon R, Fleury HJ. HIV-1 antiretroviral drug resistance in recently infected patients in Abidjan, Côte d'Ivoire: A 4-year survey, 2002-2006. AIDS Res Hum Retroviruses 2007; 23:1155-60. [PMID: 17919113 DOI: 10.1089/aid.2007.0072] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We performed HIV-1 drug resistance genotypic analysis of viral isolates from 100 antiretroviral (ARV)-naive, recently HIV-1-infected (between 2002 and 2006) individuals from Abidjan (Côte d'Ivoire). The overall prevalence of HIV-1 variants with resistance mutations to reverse transcriptase, protease, or fusion inhibitors was 6%. The majority of isolates were CRF02_AG. Compared with a previous study carried out by our group in 2001-2002 in a similar population in Abidjan, our findings confirm the circulation and transmission of HIV-1 carrying key ARV drug resistance mutation.
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Affiliation(s)
- Thomas d'Aquin Toni
- Programme PAC-CI/Primo-CI ANRS 1220, Abidjan, Côte d'Ivoire
- Centre Intégré de Recherches Biocliniques d'Abidjan (CIRBA), Abidjan, Côte d'Ivoire
| | - Bernard Masquelier
- Laboratoire de Virologie EA 2968, Université Victor Segalen Bordeaux 2, Bordeaux, France
| | - Albert Minga
- Programme PAC-CI/Primo-CI ANRS 1220, Abidjan, Côte d'Ivoire
| | - Xavier Anglaret
- Programme PAC-CI/Primo-CI ANRS 1220, Abidjan, Côte d'Ivoire
- ISPED, INSERM U593, Université Victor Segalen Bordeaux 2, Bordeaux, France
| | | | - Ali Coulibaly
- Programme PAC-CI/Primo-CI ANRS 1220, Abidjan, Côte d'Ivoire
| | - Henri Chenal
- Centre Intégré de Recherches Biocliniques d'Abidjan (CIRBA), Abidjan, Côte d'Ivoire
| | - François Dabis
- ISPED, INSERM U593, Université Victor Segalen Bordeaux 2, Bordeaux, France
| | - Roger Salamon
- ISPED, INSERM U593, Université Victor Segalen Bordeaux 2, Bordeaux, France
| | - Hervé J. Fleury
- Laboratoire de Virologie EA 2968, Université Victor Segalen Bordeaux 2, Bordeaux, France
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Sakarovitch C, Rouet F, Murphy G, Minga AK, Alioum A, Dabis F, Costagliola D, Salamon R, Parry JV, Barin F. Do Tests Devised to Detect Recent HIV-1 Infection Provide Reliable Estimates of Incidence in Africa? J Acquir Immune Defic Syndr 2007; 45:115-22. [PMID: 17460475 DOI: 10.1097/qai.0b013e318050d277] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The objective of this study was to assess the performance of 4 biologic tests designed to detect recent HIV-1 infections in estimating incidence in West Africa (BED, Vironostika, Avidity, and IDE-V3). These tests were assessed on a panel of 135 samples from 79 HIV-1-positive regular blood donors from Abidjan, Côte d'Ivoire, whose date of seroconversion was known (Agence Nationale de Recherches sur le SIDA et les Hépatites Virales 1220 cohort). The 135 samples included 26 from recently infected patients (< or =180 days), 94 from AIDS-free subjects with long-standing infection (>180 days), and 15 from patients with clinical AIDS. The performance of each assay in estimating HIV incidence was assessed through simulations. The modified commercial assays gave the best results for sensitivity (100% for both), and the IDE-V3 technique gave the best result for specificity (96.3%). In a context like Abidjan, with a 10% HIV-1 prevalence associated with a 1% annual incidence, the estimated test-specific annual incidence rates would be 1.2% (IDE-V3), 5.5% (Vironostika), 6.2% (BED), and 11.2% (Avidity). Most of the specimens falsely classified as incident cases were from patients infected for >180 days but <1 year. The authors conclude that none of the 4 methods could currently be used to estimate HIV-1 incidence routinely in Côte d'Ivoire but that further adaptations might enhance their accuracy.
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Affiliation(s)
- Charlotte Sakarovitch
- INSERM EMI 03 38, Institut de Santé Publique, Epidémiologie, et Développement (ISPED), Université Victor Segalen Bordeaux 2, Bordeaux, France.
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Betsi NA, Koudou BG, Cissé G, Tschannen AB, Pignol AM, Ouattara Y, Madougou Z, Tanner M, Utzinger J. Effect of an armed conflict on human resources and health systems in Côte d'Ivoire: Prevention of and care for people with HIV/AIDS. AIDS Care 2007; 18:356-65. [PMID: 16809113 DOI: 10.1080/09540120500200856] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
In September 2002, an armed conflict erupted in Côte d'Ivoire which has since divided the country in the government-held south and the remaining territory controlled by the 'Forces Armées des Forces Nouvelles' (FAFN). There is concern that conflict-related population movements, breakdown of health systems and food insecurity could significantly increase the incidence of HIV infections and other sexually-transmitted infections, and hence jeopardize the country's ability to cope with the HIV/AIDS epidemic. Our objective was to assess and quantify the effect this conflict had on human resources and health systems that provide the backbone for prevention, treatment and care associated with HIV/AIDS. We obtained data through a questionnaire survey targeted at key informants in 24 urban settings in central, north and west Côte d'Ivoire and reviewed relevant Ministry of Health (MoH) records. We found significant reductions of health staff in the public and private sector along with a collapse of the health system and other public infrastructures, interruption of condom distribution and lack of antiretrovirals. On the other hand, there was a significant increase of non-governmental organizations (NGOs), some of which claim a partial involvement in the combat with HIV/AIDS. The analysis shows the need that these NGOs, in concert with regional and international organizations and United Nations agencies, carry forward HIV/AIDS prevention and care efforts, which ought to be continued through the post-conflict stage and then expanded to comprehensive preventive care, particularly antiretroviral treatment.
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Affiliation(s)
- N A Betsi
- Centre Suisse de Recherches Scientifiques, Abidjan, Côte d'Ivoire
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15
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Derache A, Traore O, Koita V, Sylla A, Tubiana R, Simon A, Canestri A, Carcelain G, Katlama C, Calvez V, Cisse M, Marcelin AG. Genetic Diversity and Drug Resistance Mutations in HIV type 1 from Untreated Patients in Bamako, Mali. Antivir Ther 2007. [DOI: 10.1177/135965350701200117] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective To determine the genetic diversity of HIV-1 reverse transcriptase (RT) and protease sequences and the presence of mutations linked to antiretroviral (ARV) resistance in treatment-naive, HIV-1-infected individuals living in Mali. Methods Ninety-eight samples from ARV drug-naive, HIV-1-infected patients were collected in one clinical centre in Bamako, Mali in 2005. RT and protease genes were sequenced in order to perform phylogenetic and resistance analyses. Results The most prevalent subtype was CRF02-AG (75% of cases), followed by the CRF06-cpx subtype (20%). Intersubtype recombinants between CRF02-AG, CRF01-AE and CRF06-cpx were also described in 5% of cases. After 4 years of ARV use in Mali, two previously untreated individuals (2%; 95% CI: 0.00–4.77%) were found to have resistant viruses, one with a single nucleoside mutation and one with K103N non-nucleoside reverse transcriptase inhibitor resistance mutation. No evidence of transmitted protease inhibitor resistance mutations was found. Conclusion These data provide direct evidence for the circulation of HIV-1 isolates containing resistance mutations in treatment-naive patients in Mali. Since ARV use in Mali began, more than 5,000 patients have started treatment, mostly with Triomune (stavudine/lamivu-dine/nevirapine). The resistance-associated mutations detected in the present study are consistent with this treatment regimen. Continued surveillance will be required to monitor the emergence of ARV resistance in this country.
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Affiliation(s)
- Anne Derache
- Department of Virology, Pitié-Salpêtrière Hospital, AP-HP, EA 2387, Université Pierre et Marie Curie, Paris, France
| | - Ousmane Traore
- Centre d'Ecoute, de Soins, d'Animations et de Conseils, Bamako, Mal
| | - Victoria Koita
- Centre d'Ecoute, de Soins, d'Animations et de Conseils, Bamako, Mal
| | - Aliou Sylla
- Centre d'Ecoute, de Soins, d'Animations et de Conseils, Bamako, Mal
- Cellule Multisectorielle de Lutte contre le Sida, Bamako, Mal
| | - Roland Tubiana
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Anne Simon
- Department of Internal Medicine Pitié-Salpêtrière Hospital, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Ana Canestri
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Guislaine Carcelain
- Department of Immunology, Pitié-Salpêtrière Hospital, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Christine Katlama
- Department of Infectious Diseases, Pitié-Salpêtrière Hospital, AP-HP, Université Pierre et Marie Curie, Paris, France
| | - Vincent Calvez
- Department of Virology, Pitié-Salpêtrière Hospital, AP-HP, EA 2387, Université Pierre et Marie Curie, Paris, France
| | - Mamadou Cisse
- Centre d'Ecoute, de Soins, d'Animations et de Conseils, Bamako, Mal
| | - Anne-Geneviève Marcelin
- Department of Virology, Pitié-Salpêtrière Hospital, AP-HP, EA 2387, Université Pierre et Marie Curie, Paris, France
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Tebit DM, Ganame J, Sathiandee K, Nagabila Y, Coulibaly B, Krausslich HG. Diversity of HIV in Rural Burkina Faso. J Acquir Immune Defic Syndr 2006; 43:144-52. [PMID: 16951652 DOI: 10.1097/01.qai.0000228148.40539.d3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
SUMMARY : On introduction of a program for prevention of mother-to-child transmission (PMTCT) of HIV in Nouna, rural Burkina Faso, we determined HIV prevalence in this region to be 3.6%, which is significantly lower than the 7% reported for 2 major cities of Burkina Faso. Forty-three samples from drug-naive pregnant women and patients before introduction of antiretroviral therapy (ART) were genotypically characterized in gag, pol, and env regions. One individual each was infected with HIV-2 or dually infected with HIV-1 and HIV-2. The most dominant HIV-1 subtypes were CRF02_AG and CRF06_cpx, similar to what has been observed in other West African countries. A discordant genotype was observed in almost half of the analyzed samples, with most putative recombinants deriving from CRF02_AG and CRF06_cpx. Recently reported strains like the CRF09_cpx and the sub-subtype A3 as well as some unique recombinant forms of HIV like D/D/CRF02_AG and CRF02_AG/CRF02.AG/CRF_09cpx were also detected. Analysis of drug resistance-associated polymorphisms detected the nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance mutations K103N/E and V118I in 1 individual each, suggesting transmission of drug-resistant viruses or prior use of antiretroviral drugs. Resistance-associated polymorphisms (K20I and M36I) were prevalent in the complete protease (PR) region, but no primary drug resistance mutations were detected. Analysis of the HR1 and HR2 regions of gp41, important for T-20 sensitivity, revealed no known resistance mutations but several polymorphisms of unknown importance. Monitoring for drug resistance mutations among naive subjects is important in this area on introduction of antiretroviral drugs.
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Affiliation(s)
- Denis M Tebit
- Abteilung Virologie, Universitatsklinikum Heidelberg, Heidelberg, Germany
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17
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Marechal V, Jauvin V, Selekon B, Leal J, Pelembi P, Fikouma V, Gabrie P, Heredeibona LS, Goumba C, Serdouma E, Ayouba A, Fleury H. Increasing HIV type 1 polymorphic diversity but no resistance to antiretroviral drugs in untreated patients from Central African Republic: a 2005 study. AIDS Res Hum Retroviruses 2006; 22:1036-44. [PMID: 17067275 DOI: 10.1089/aid.2006.22.1036] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
As the HIV-1 pandemic becomes increasingly complex and as new countries acceed to antiretroviral drugs, the molecular characterization of HIV-1 strains circulating has important implications for vaccine research and for the efficacy of treatments. To follow the evolution of HIV-1 diversity in African countries, we have carried out a molecular analysis of HIV-1 strains collected from 150 HIV-1-positive pregnant women recruited in Bangui, Central African Republic (CAR). We have sequenced reverse transcriptase (RT) and protease (PROT) genes to (1) characterize the subtypes and CRFs, (2) describe the polymorphism of RT and PROT, particularly at the positions of drug resistance mutations in subtype B, and (3) observe potential drug resistance mutations and evaluate the prevalence of isolates bearing such mutations in this untreated population. The results showed that there is a very high and increasing diversity of HIV-1 strains circulating in CAR; out of 117 samples sequenced, we have observed 45 CRF11_cpx, 22 subtypes A1, 13 subtypes G, 7 subtypes CRF01_AE, 3 subtypes B, 3 subtypes CRF02_AG, 2 of each subtype F2 and CRF09_cpx, and one of each subtype D, J, C, H, CRF06_cpx, CRF13_cpx, and CRF19_cpx; the remaining 13 strains showed discordant genomic results suggesting multiple recombinations leading to mosaic viruses. The polymorphism of RT and PROT was high compared to subtype B, particularly at some positions that have been involved in antiretroviral resistance in subtype B, but we could not observe any major resistance mutation in this sample of untreated patients. The prevalence of drug resistance mutations in this population was therefore clearly under the WHO 5% threshold.
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18
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Lawrence P, Lutz MF, Saoudin H, Frésard A, Cazorla C, Fascia P, Pillet S, Pozzetto B, Lucht F, Bourlet T. Analysis of polymorphism in the protease and reverse transcriptase genes of HIV type 1 CRF02-AG subtypes from drug-naive patients from Saint-Etienne, France. J Acquir Immune Defic Syndr 2006; 42:396-404. [PMID: 16773024 DOI: 10.1097/01.qai.0000221675.83950.4a] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
SUMMARY : The proportion of non-B HIV-1 variants is increasing in Western Europe. The impact of the high polymorphism in the protease and reverse transcriptase genes, as recently described for CRF02-AG isolates of African origin, on antiretroviral resistance is still disputed. We first examined the polymorphism of these genes in CRF02-AG strains recovered from drug-naive patients followed at the University Hospital of Saint-Etienne in France, most of these of French origin and harboring a clonal strain as elicited by phylogenic analysis. The first plasma sample detected positive from 31 CRF02-AG and 23 B strains was used to compare sequences with their respective subtype consensus strain. The overall number of mutations was dramatically higher for CRF02-AG strains than for B strains in both protease and reverse transcriptase genes (P < 0.0001 and 0.009, respectively). In addition, no statistically significant difference in the number of therapeutic failures, mean CD4 cell count, and viral load was observed between 22 and 45 patients infected with CRF02-AG or B strains, respectively, during a mean treatment period of 25.5 months. Even if no striking antiretroviral failure linked to this polymorphism was observed during short-term follow-up, its impact on long-term therapy will have to be extensively evaluated in patients infected by non-B HIV-1 variants.
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Affiliation(s)
- Philip Lawrence
- Laboratory of Virology, GIMAP, Faculty of Medicine Jacques Lisfranc and University Hospital of Saint-Etienne, Saint-Etienne cedex 02, France
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19
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Fleury HJ, Toni T, Lan NTH, Hung PV, Deshpande A, Recordon-Pinson P, Boucher S, Lazaro E, Jauvin V, Lavignolle-Aurillac V, Lebel-Binay S, Cheret A, Masquelier B. Susceptibility to antiretroviral drugs of CRF01_AE, CRF02_AG, and subtype C viruses from untreated patients of Africa and Asia: comparative genotypic and phenotypic data. AIDS Res Hum Retroviruses 2006; 22:357-66. [PMID: 16623640 DOI: 10.1089/aid.2006.22.357] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Non-B HIV-1 viruses are predominant in developing countries where access to antiretroviral drugs (ARVs) is progressively being intensified. It is important to obtain more data on the susceptibility of these viruses to available ARVs. CRF01_AE, CRF02_AG, and subtype C strains of HIV-1 obtained from untreated patients from Vietnam, Cote d'Ivoire, and India were analyzed for their in vitro susceptibility to NRTIs, NNRTIs, PIs, and an entry inhibitor (T-20) using a recombinant viral assay (PHENOSCRIPT). The corresponding viruses, which had been previously sequenced in reverse transcriptase (RT), protease (prot), plus envelope (env) C2/V3 genes and had therefore been fully characterized, were further sequenced in env HR1 + HR2 regions. CRF01_AE isolates are sensitive to NRTIs and NNRTIs with the exception of one isolate that exhibits a decreased susceptibility to NNRTIs associated with a I135T substitution in RT. CRF02_AG and subtype C viruses are sensitive to NRTIs and NNRTIs but some CRF02_AG isolates tend to be resistant to abacavir, potentially related to associated substitutions of RT at positions 123 (D123N) plus 135 (I135V). Whereas all but one CRF01_AE isolates are fully susceptible to PIs, some CRF02_AG and, more frequently, some subtype C isolates are resistant to atazanavir. The role of substitutions in prot at positions of secondary resistance mutations 20, 36, 63, and 82 is raised with a potentially crucial role of the V82I substitution. Finally, all viruses tested, regardless of the CRF or subtype, are fully susceptible to T-20.
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Affiliation(s)
- Herve J Fleury
- Laboratoire de Virologie UPRES EA 2968, Université de Bordeaux 2, 33076 Bordeaux France.
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20
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Bouzeghoub S, Jauvin V, Recordon-Pinson P, Garrigue I, Amrane A, Belabbes EH, Fleury HJ. High diversity of HIV type 1 in Algeria. AIDS Res Hum Retroviruses 2006; 22:367-72. [PMID: 16623641 DOI: 10.1089/aid.2006.22.367] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
We have sequenced different genes of HIV-1 strains from infected individuals recruited in various geographic parts of Algeria; phylogenetic trees were constructed yielding molecular characterization of these strains. Subtype B accounts for 56% of the samples studied and is therefore the predominant subtype, particularly in the north part of the country; but there is a high diversity of the virus including CRF02_AG, CRF06_cpx, CRF02/CRF06 interrecombinants, and different other intersubtype and/or inter-CRF recombinants. The prevalence of these non-B viruses increases in the south part of Algeria that borders sub-Saharan African countries. The high diversity of HIV-1 in Algeria has implications for virological follow-up, resistance surveys, and vaccine design.
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Affiliation(s)
- Salima Bouzeghoub
- Laboratoire National de Référence VIH/SIDA, Institut Pasteur d?Algérie, Alger, Algérie
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21
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Toni TD, Masquelier B, Lazaro E, Dore-Mbami M, Ba-Gomis FO, Téa-Diop Y, Kouakou K, Diby J, Sia E, Soppi S, Essien S, Schrive MH, Pinson P, Chenal H, Fleury HJ. Characterization of nevirapine (NVP) resistance mutations and HIV type 1 subtype in women from Abidjan (Côte d'Ivoire) after NVP single-dose prophylaxis of HIV type 1 mother-to-child transmission. AIDS Res Hum Retroviruses 2005; 21:1031-4. [PMID: 16379606 DOI: 10.1089/aid.2005.21.1031] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Nevirapine (NVP) single dose is widely used in developing countries to prevent HIV-1 mother-to-child transmission. However, this regimen selects key drug resistance mutations that can impair further HAART efficacy. We studied the HIV-1 reverse transcriptase genotype from 29 Ivoirian women 1 month after an NVP single-dose prophylaxis. NVP resistance mutations were observed in six (20.7%) women. The majority of the isolates were CRF02_AG. These results confirm previous studies and suggest the need for different prophylaxis regimens in this setting.
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Affiliation(s)
- Thomas D'Aquin Toni
- Centre Intégré de Recherches Biocliniques d'Abidjan, Abidjan, Côte d'Ivoire.
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22
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Ly N, Recordon-Pinson P, Phoung V, Srey C, Kruy LS, Koum K, Chhum V, Glaziou P, Fleury HJ, Reynes JM. Characterization of mutations in HIV type 1 isolates from 144 Cambodian recently infected patients and pregnant women naive to antiretroviral drugs. AIDS Res Hum Retroviruses 2005; 21:971-6. [PMID: 16386116 DOI: 10.1089/aid.2005.21.971] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A baseline study has been conducted to determine the polymorphism of reverse transcriptase, protease, and envelope genes of HIV-1 isolates from 146 antiretroviral drug-naive Cambodian patients including 22 seroconverters and 124 pregnant women having been diagnosed HIV positive for less than 1 year. Amplification of at least one gene was successful for 144 isolates. All three genes were obtained for 136 isolates. Subtyping showed that CRF01_AE was predominant (130 cases). According to the ANRS September 2004 list, polymorphism substitutions (>50% versus the subtype B consensus) of CRF01_AE at drug resistance positions were observed only in protease: I13V (81%), E35D (87%), M36I (100%), R41K (96%), and H69K (100%). Two strains bore one major resistance mutation to PIs: M46I and N88D. Five other strains carried drug resistance mutations to RTIs: K70R (one strain), V75M (three strains), and K101E (one strain). Of the isolates 4.9% had drug resistance mutations to antiretroviral drugs.
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Affiliation(s)
- Nary Ly
- Institut Pasteur du Cambodge, BP983, Phnom Penh, Cambodia
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23
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Rouet F, Ekouevi DK, Chaix ML, Burgard M, Inwoley A, Tony TD, Danel C, Anglaret X, Leroy V, Msellati P, Dabis F, Rouzioux C. Transfer and evaluation of an automated, low-cost real-time reverse transcription-PCR test for diagnosis and monitoring of human immunodeficiency virus type 1 infection in a West African resource-limited setting. J Clin Microbiol 2005; 43:2709-17. [PMID: 15956387 PMCID: PMC1151915 DOI: 10.1128/jcm.43.6.2709-2717.2005] [Citation(s) in RCA: 191] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
There is an urgent need for low-cost human immunodeficiency virus type 1 (HIV-1) viral load (VL) monitoring technologies in resource-limited settings. An automated TaqMan real-time reverse transcription-PCR (RT-PCR) assay was transferred to the laboratory of the Centre de Diagnostic et de Recherches sur le SIDA, Abidjan, Côte d'Ivoire, and assessed for HIV-1 RNA VL testing in 806 plasma samples collected within four ANRS research programs. The detection threshold and reproducibility of the assay were first determined. The quantitative results obtained with this assay were compared with two commercial HIV-1 RNA kits (the Versant version 3.0 and Monitor version 1.5 assays) in specimens harboring mainly the circulating recombinant form 02 strain (CRF02). The clinical evaluation of this test was done in different situations including the early diagnosis of pediatric infection and the monitoring of antiretroviral-treated patients. The quantification limit of our method was 300 copies/ml. The HIV-1 RNA values obtained by real-time PCR assay were highly correlated with those obtained by the Versant kit (r = 0.901; P < 0.001) and the Monitor test (r = 0.856; P < 0.001) and homogeneously distributed according to HIV-1 genotypes. For the early diagnosis of pediatric HIV-1 infection, the sensitivity and specificity of the real-time PCR assay were both 100% (95% confidence intervals of 93.7 to 100.0 and 98.3 to 100.0, respectively), compared to the Versant results. Following initiation of antiretroviral treatment, the kinetics of HIV-1 RNA levels were very comparable, with a similar proportion of adults and children below the detection limit during follow-up with our technique and the Versant assay. The TaqMan real-time PCR (12 dollars per test) is now routinely used to monitor HIV-1 infection in our laboratory. This technology should be further evaluated in limited-resource countries where strains other than CRF02 are prevalent.
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Affiliation(s)
- Francois Rouet
- Centre de Diagnostic et de Recherches sur le SIDA, Abidjan, Côte d'Ivoire.
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Sachdeva N, Sehgal S, Arora SK. Frequency of Drug-Resistant Variants of HIV-1 Coexistent With Wild-Type in Treatment-Naive Patients of India. J Int AIDS Soc 2005; 7:68. [PMID: 19825133 PMCID: PMC2804708 DOI: 10.1186/1758-2652-7-3-68] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Context Over the past few years, reports of emergence and transmission of drug-resistant strains of HIV have increased, especially in western countries. In the context of increased widespread use of zidovudine- and lamivudine-based combinations in India, coupled with the genetic diversity of HIV, it is essential to generate preliminary data on the frequency of zidovudine- and lamivudine-resistant variants of HIV-1 in North India. Objectives In the present study, the authors screened for mutations in the pol gene of HIV-1 associated with resistance to zidovudine and lamivudine in HIV-infected treatment-naive patients from North India. Design and Patients The mutations were screened at codons 70 and 215 (conferring resistance to zidovudine) and at codon 184 (conferring resistance to lamivudine) by using a nested amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) approach from the proviral DNA of 60 patients. Results Most of the patients showed a mixture of both wild-type and mutant virus. In all but 1 patient, wild-type virus was observed with respect to each codon. Mutant variants were also observed in many patients, especially at codon 70 (48 patients [80%]) and codon 184 (19 patients [31.67%]). In contrast, the frequency of mutation at codon 215 was found to be very low (1 patient [1.67%]). Conclusion In this sample of treatment-naive HIV-1-infected patients in North India, a high proportion of mutant variants harbored mutations in the pol gene at codons- 70 and 184 coexisting with wild-type HIV-1.
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Affiliation(s)
- Naresh Sachdeva
- Department of Immunopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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25
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Kinomoto M, Appiah-Opong R, Brandful JAM, Yokoyama M, Nii-Trebi N, Ugly-Kwame E, Sato H, Ofori-Adjei D, Kurata T, Barre-Sinoussi F, Sata T, Tokunaga K. HIV‐1 Proteases from Drug‐Naive West African Patients Are Differentially Less Susceptible to Protease Inhibitors. Clin Infect Dis 2005; 41:243-51. [PMID: 15983923 DOI: 10.1086/431197] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2004] [Accepted: 01/08/2005] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Now that highly active antiretroviral therapy (HAART) is being initiated on a large scale in West Africa, it remains controversial whether protease inhibitors (PIs), originally designed and tested against human immunodeficiency virus type 1 (HIV-1) subtype B, are equally effective against the non-B subtypes that are prevalent in West African countries. In this study, we investigated whether Ghanaian HIV-1 isolates, as representatives of West African isolates, are susceptible to PIs. METHODS We first generated an HIV-1 protease cassette vector proviral DNA carrying a luciferase gene, which allows patient-derived HIV-1 proteases to be inserted and to be subjected to both genotypic and phenotypic assays. HIV-1 protease genes derived from 39 treatment-naive Ghanaian patients were used in this experiment as representatives of West African strains. The cloned patient-derived HIV-1 protease genes were first sequenced and then genetically compared. Phenotypic analysis was performed with Ghanaian HIV-1 protease-chimeric viruses in the presence of 6 different PIs. Structural models of HIV-1 protease homodimers were constructed by the molecular modeling software. RESULTS Genetic analysis of cloned patient-derived HIV-1 protease genes indicated that most of the Ghanaian HIV-1 proteases are placed as subtype CRF02_AG strains, which are phylogenetically distant from subtype B strains, and that Ghanaian HIV-1 proteases do not harbor known major mutations influencing drug resistance but commonly carry 2-3 minor mutations. Phenotypic analysis performed with HIV-1 protease-recombinant viruses in the presence of 6 different PIs revealed that Ghanaian HIV-1 proteases are differentially less susceptible to the PIs. In support of this finding of differential susceptibility, structural analysis showed a significant distortion of nelfinavir, but not of amprenavir, in the Ghanaian protease pocket, suggesting nelfinavir might be less insertable into the Ghanaian protease than into the protease of subtype B. CONCLUSIONS These findings provide implications for the combination of PIs during the introduction of HAART into West Africa.
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Affiliation(s)
- Masanobu Kinomoto
- Department of Pathology, National Institute of Infectious Diseases, Tokyo, Japan
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Toni T, Adjé-Touré C, Vidal N, Minga A, Huet C, Borger MY, Recordon-Pinson P, Masquelier B, Nolan M, Nkengasong J, Fleury HJ, Delaporte E, Peeters M. Presence of CRF09_cpx and complex CRF02_AG/CRF09_cpx recombinant HIV type 1 strains in Côte d'Ivoire, West Africa. AIDS Res Hum Retroviruses 2005; 21:667-72. [PMID: 16060839 DOI: 10.1089/aid.2005.21.667] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Based on partial env and pol (protease and RT) subtyping, we recently documented that the majority (>80%) of the HIV-1 strains that circulate in Côte d'Ivoire were CRF02_AG and about 11% were recombinants or could not be clearly assigned to a known subtype or CRF. In order to determine in more detail the precise structure of these viruses we sequenced the full-length genomes for six such strains. Bootscan and phylogenetic tree analysis showed that four strains were complex and unique CRF02_AG/CRF09_cpx recombinants, one was a CRF02_AG/CRF06_cpx recombinant, and one was a pure CRF09_cpx. Reanalysis of the remaining recombinants asserted the predominance of CRF09_cpx within intersubtype recombinants and circulation of CRF09_cpx in Côte d'Ivoire. More detailed analysis of the CRF09_cpx strains revealed also that part of the pol gene belonged to subtype K. This is the first time that such recombinants are described.
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Vergne L, Diagbouga S, Kouanfack C, Aghokeng A, Butel C, Laurent C, Noumssi N, Tardy M, Sawadogo A, Drabo J, Hien H, Zekeng L, Delaporte E, Peeters M. HIV-1 Drug-Resistance Mutations among Newly Diagnosed Patients before Scaling-Up Programmes in Burkina Faso and Cameroon. Antivir Ther 2005. [DOI: 10.1177/135965350601100511] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We analysed whether mutations associated with resistance to antiretroviral (ARV) drugs circulate among treatment-naive HIV-1-infected individuals at a period when these drugs started to become more widely available in Africa. Overall, major resistance mutations in the pol gene, as defined by the International AIDS Society Resistance Testing-USA panel, were observed in 16 treatment-naive individuals. Eight of the 97 patients tested in Burkina Faso bore mutations conferring resistance to one drug class of ARV drugs: two to nucleoside reverse transcriptase inhibitors (NRTIs; M41L [ n=1], M41L+T69S [ n=1]), four to non-NRTIs (NNRTIs; V106A/V [ n=1] and V108I [ n=3]) and two to protease inhibitors (PIs; L33F [ n=2]). In Cameroon, resistance mutations were identified in 8 of 102 patients: three to PIs (M46I/L [ n=2], L33F [ n=1]), three to NRTIs (T69N/T [ n=1], M184V [ n=1], A62V [ n=1]) and two to NNRTIs (P236L [ n=1], V108I [ n=1]). It is important to note that not all geno-typic drug-resistance algorithms give similar interpretations to the observed mutations. Population surveillance for ARV drug resistance is required and should be included in all implementation programmes.
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Affiliation(s)
- Laurence Vergne
- UMR145, Institut de Recherche pour le Développement (IRD) and University of Montpellier, Montpellier, France
| | | | | | - Avelin Aghokeng
- UMR145, Institut de Recherche pour le Développement (IRD) and University of Montpellier, Montpellier, France
| | - Christelle Butel
- UMR145, Institut de Recherche pour le Développement (IRD) and University of Montpellier, Montpellier, France
| | - Christian Laurent
- UMR145, Institut de Recherche pour le Développement (IRD) and University of Montpellier, Montpellier, France
| | | | - Michèle Tardy
- Hôpital de Jour, Central Hospital, Yaoundé, Cameroon
| | | | | | - Hervé Hien
- Centre Muraz, Bobo Dioulasso, Burkina Faso
| | | | - Eric Delaporte
- UMR145, Institut de Recherche pour le Développement (IRD) and University of Montpellier, Montpellier, France
| | - Martine Peeters
- UMR145, Institut de Recherche pour le Développement (IRD) and University of Montpellier, Montpellier, France
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Lazzari S, de Felici A, Sobel H, Bertagnolio S. HIV drug resistance surveillance: summary of an April 2003 WHO consultation. AIDS 2004; 18 Suppl 3:S49-53. [PMID: 15322485 DOI: 10.1097/00002030-200406003-00010] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The widespread use of any antimicrobial agent, including antiretroviral agents, has the potential to select drug-resistant populations of microorganisms. HIV drug-resistant strains have been recognized as a serious threat to the efficacy of current antiretroviral treatments and could jeopardize efforts to increase access to treatment in countries most affected by the HIV epidemic. The WHO Global HIV Drug Resistance Surveillance Programme aims at enhancing and enabling the response to the threat of antiretroviral drug resistance by assessing the geographical and temporal trends in HIV drug resistance, increasing our understanding of the determinants of HIV drug resistance, and identifying ways to minimize its appearance, evolution and spread. Based on a global network of experts and collaborating institutions, the programme is developing and field-testing tools and guidelines for the regular monitoring of the level and spread of HIV resistance, particularly in treatment-naive patients. Although relevant progress has been made, several important challenges still exist to the implementation of this essential and innovative programme.
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Konings FAJ, Nyambi PN. V118I substitution in the reverse transcriptase gene of HIV type 1 CRF02_AG strains infecting drug-naive individuals in Cameroon. AIDS Res Hum Retroviruses 2004; 20:673-8. [PMID: 15242545 DOI: 10.1089/0889222041217464] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We describe the resistance-associated substitutions that are present in the reverse transcriptase (RT) genes of HIV-1 CRF02_AG strains infecting drug-naive villagers of Cameroon. The 11 sequences analyzed were previously subtyped as CRF02_AG in the gag, pro, and env genes, and this work revealed that most (10/11) had a concordant subtype (CRF02_AG) in the pol gene, while one sequence had discordant subtype (A1) in the pol gene. Classification of the CRF02_AG sequences was further confirmed by recombination breakpoint analysis, which revealed a mosaic composition similar to the reference strain IbNG. Analysis of the RT genes for resistance-associated substitutions revealed two sequences containing a V118I substitution. Even though no other resistance-associated substitutions were found, the presence of V118I, which is implicated in resistance to reverse transcriptase inhibitors, in CRF02_AG strains infecting drug-naive individuals should be considered when introducing these antiretrovirals in areas where CRF02_AG is the predominant subtype, such as Cameroon.
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Affiliation(s)
- Frank A J Konings
- Department of Microbiology, New York University School of Medicine, 10010, USA
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