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Tchouwa GF, Eymard-Duvernay S, Cournil A, Lamare N, Serrano L, Butel C, Bertagnolio S, Mpoudi-Ngole E, Raizes E, Aghokeng AF. Prevalence of pretreatment HIV drug resistance in Cameroon following a nationally representative WHO survey. J Antimicrob Chemother 2019; 73:2468-2474. [PMID: 29931063 DOI: 10.1093/jac/dky221] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 05/15/2018] [Indexed: 11/15/2022] Open
Abstract
Background Pretreatment HIV drug resistance (PDR) has the potential to affect treatment outcome and mortality. We present here the first nationally representative PDR study conducted in Cameroon. Methods From February to July 2015, HIV-infected ART initiators were recruited from 24 randomly selected clinics situated in both urban and rural regions. Dried blood spot specimens were collected from study participants at these clinics and centralized in a reference laboratory in Yaoundé, Cameroon, for drug resistance testing. HIV drug resistance mutations were identified using the Stanford algorithm. Results Overall, from the 379 participants recruited, 321 pol sequences were successfully interpreted. Two hundred and five sequences were from patients attending urban ART clinics and 116 from patients seen at rural facilities. Nine percent of sequences (29/321) were from participants reporting previous exposure to antiretrovirals. PDR prevalence among all initiators was 10.4% (95% CI 5.4%-19.1%), with 14.2% (95% CI 6.6%-27.9%) reported in urban areas and 4.3% (95% CI 1.2%-14.3%) in rural areas. Among participants with no prior exposure to antiretrovirals, PDR prevalence was 10.4% (95% CI 4.7%-21.5%) overall, with 13.5% (95% CI 5.1%-31.5%) and 5.3% (95% CI 1.4%-17.5%) reported in urban and rural areas, respectively. Conclusions Our findings indicate that at least 10% of patients initiating ART in Cameroon carry viruses with PDR and may be at risk of premature ART failure. The high level of NNRTI-associated resistance is of particular concern and supports introduction of drugs with a higher genetic barrier to resistance.
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Affiliation(s)
- Gaëlle F Tchouwa
- Centre de Recherche sur les Maladies Emergentes et Reemergentes (CREMER), Virology Laboratory IMPM-IRD, IMPM, Yaoundé, Cameroon
| | - Sabrina Eymard-Duvernay
- Institut de Recherche pour le Développement (IRD) UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
| | - Amandine Cournil
- Institut de Recherche pour le Développement (IRD) UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
| | - Nadine Lamare
- Centre de Recherche sur les Maladies Emergentes et Reemergentes (CREMER), Virology Laboratory IMPM-IRD, IMPM, Yaoundé, Cameroon
| | - Laetitia Serrano
- Institut de Recherche pour le Développement (IRD) UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
| | - Christelle Butel
- Institut de Recherche pour le Développement (IRD) UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
| | | | - Eitel Mpoudi-Ngole
- Centre de Recherche sur les Maladies Emergentes et Reemergentes (CREMER), Virology Laboratory IMPM-IRD, IMPM, Yaoundé, Cameroon
| | - Elliot Raizes
- Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Avelin F Aghokeng
- Centre de Recherche sur les Maladies Emergentes et Reemergentes (CREMER), Virology Laboratory IMPM-IRD, IMPM, Yaoundé, Cameroon.,Institut de Recherche pour le Développement (IRD) UMI 233, INSERM U1175, Université de Montpellier, Unité TransVIHMI, Montpellier, France
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Niama FR, Vidal N, Diop-Ndiaye H, Nguimbi E, Ahombo G, Diakabana P, Bayonne Kombo ÉS, Mayengue PI, Kobawila SC, Parra HJ, Toure-Kane C. HIV-1 genetic diversity and primary drug resistance mutations before large-scale access to antiretroviral therapy, Republic of Congo. BMC Res Notes 2017; 10:243. [PMID: 28679441 PMCID: PMC5498887 DOI: 10.1186/s13104-017-2550-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 06/19/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In this work, we investigated the genetic diversity of HIV-1 and the presence of mutations conferring antiretroviral drug resistance in 50 drug-naïve infected persons in the Republic of Congo (RoC). Samples were obtained before large-scale access to HAART in 2002 and 2004. METHODS To assess the HIV-1 genetic recombination, the sequencing of the pol gene encoding a protease and partial reverse transcriptase was performed and analyzed with updated references, including newly characterized CRFs. The assessment of drug resistance was conducted according to the WHO protocol. RESULTS Among the 50 samples analyzed for the pol gene, 50% were classified as intersubtype recombinants, charring complex structures inside the pol fragment. Five samples could not be classified (noted U). The most prevalent subtypes were G with 10 isolates and D with 11 isolates. One isolate of A, J, H, CRF05, CRF18 and CRF37 were also found. Two samples (4%) harboring the mutations M230L and Y181C associated with the TAMs M41L and T215Y, respectively, were found. CONCLUSION This first study in the RoC, based on WHO classification, shows that the threshold of transmitted drug resistance before large-scale access to antiretroviral therapy is 4%.
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Affiliation(s)
- Fabien Roch Niama
- Laboratoire National de Santé Publique, Unité de Biologie Moléculaire, BP 120 Avenue du Général De Gaule, Brazzaville, Republic of Congo. .,Laboratoire de Bactériologie et Virologie, Hôpital Le Dantec, Dakar, Sénégal. .,Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville, Republic of Congo.
| | - Nicole Vidal
- IRD_UMI 233 TransVIHMI, Délégation Régionale Occitanie 911 avenue Agropolis, Montpellier, France
| | | | - Etienne Nguimbi
- Laboratoire National de Santé Publique, Unité de Biologie Moléculaire, BP 120 Avenue du Général De Gaule, Brazzaville, Republic of Congo
| | - Gabriel Ahombo
- Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville, Republic of Congo
| | - Philippe Diakabana
- Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville, Republic of Congo
| | | | - Pembe Issamou Mayengue
- Laboratoire National de Santé Publique, Unité de Biologie Moléculaire, BP 120 Avenue du Général De Gaule, Brazzaville, Republic of Congo.,Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville, Republic of Congo
| | - Simon-Charles Kobawila
- Faculté des Sciences et Techniques, Université Marien Ngouabi, Brazzaville, Republic of Congo
| | - Henri Joseph Parra
- Laboratoire National de Santé Publique, Unité de Biologie Moléculaire, BP 120 Avenue du Général De Gaule, Brazzaville, Republic of Congo
| | - Coumba Toure-Kane
- Laboratoire de Bactériologie et Virologie, Hôpital Le Dantec, Dakar, Sénégal
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Barennes H, Guillet S, Limsreng S, Him S, Nouhin J, Hak C, Srun C, Viretto G, Ouk V, Delfraissy JF, Ségéral O. Virological failure and HIV-1 drug resistance mutations among naive and antiretroviral pre-treated patients entering the ESTHER program of Calmette Hospital in Cambodia. PLoS One 2014; 9:e105736. [PMID: 25166019 PMCID: PMC4148321 DOI: 10.1371/journal.pone.0105736] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 07/28/2014] [Indexed: 11/19/2022] Open
Abstract
Introduction In resource limited settings, patients entering an antiretroviral therapy (ART) program comprise ART naive and ART pre-treated patients who may show differential virological outcomes. Methods This retrospective study, conducted in 2010–2012 in the HIV clinic of Calmette Hospital located in Phnom Penh (Cambodia) assessed virological failure (VF) rates and patterns of drug resistance of naive and pre-treated patients. Naive and ART pre-treated patients were included when a Viral Load (VL) was performed during the first year of ART for naive subjects or at the first consultation for pre-treated individuals. Patients showing Virological failure (VF) (>1,000 copies/ml) underwent HIV DR genotyping testing. Interpretation of drug resistance mutations was done according to 2013 version 23 ANRS algorithms. Results On a total of 209 patients, 164 (78.4%) were naive and 45 (21.5%) were ART pre-treated. Their median initial CD4 counts were 74 cells/mm3 (IQR: 30–194) and 279 cells/mm3 (IQR: 103–455) (p<0.001), respectively. Twenty seven patients (12.9%) exhibited VF (95% CI: 8.6–18.2%), including 10 naive (10/164, 6.0%) and 17 pre-treated (17/45, 37.8%) patients (p<0.001). Among these viremic patients, twenty-two (81.4%) were sequenced in reverse transcriptase and protease coding regions. Overall, 19 (86.3%) harbored ≥1 drug resistance mutations (DRMs) whereas 3 (all belonging to pre-treated patients) harbored wild-types viruses. The most frequent DRMs were M184V (86.3%), K103N (45.5%) and thymidine analog mutations (TAMs) (40.9%). Two (13.3%) pre-treated patients harbored viruses that showed a multi-nucleos(t)ide resistance including Q151M, K65R, E33A/D, E44A/D mutations. Conclusion In Cambodia, VF rates were low for naive patients but the emergence of DRMs to NNRTI and 3TC occurred relatively quickly in this subgroup. In pre-treated patients, VF rates were much higher and TAMs were relatively common. HIV genotypic assays before ART initiation and for ART pre-treated patients infection should be considered as well.
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Affiliation(s)
- Hubert Barennes
- Agence Nationale de Recherche sur le VIH et les Hepatites (ANRS), Phnom Penh, Cambodia
- ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Univ. Bordeaux, Bordeaux, France
- Epidemiology Unit, Pasteur Institute, Phnom Penh, Cambodia
- * E-mail:
| | - Stéphanie Guillet
- Agence Nationale de Recherche sur le VIH et les Hepatites (ANRS), Phnom Penh, Cambodia
- Assistance Publique - Hôpitaux de Paris (AP-HP), Département de Médecine Interne et Immunologie Clinique, Centre Hospitalier Universitaire de Bicêtre, Le Kremlin-Bicêtre, France
| | | | - Sovanvatey Him
- Hospital Calmette, Phnom Penh, Cambodia
- Ensemble pour une Solidarité Thérapeutique Hospitalière En Réseau (ESTHER), Phnom Penh, Cambodia
| | - Janin Nouhin
- HIV/Hepatitis Unit, Pasteur Institute, Phnom Penh, Cambodia
- Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Chanroeurn Hak
- Hospital Calmette, Phnom Penh, Cambodia
- Ensemble pour une Solidarité Thérapeutique Hospitalière En Réseau (ESTHER), Phnom Penh, Cambodia
| | | | - Gerald Viretto
- Ensemble pour une Solidarité Thérapeutique Hospitalière En Réseau (ESTHER), Phnom Penh, Cambodia
| | - Vara Ouk
- Hospital Calmette, Phnom Penh, Cambodia
- Ensemble pour une Solidarité Thérapeutique Hospitalière En Réseau (ESTHER), Phnom Penh, Cambodia
| | - Jean Francois Delfraissy
- Assistance Publique - Hôpitaux de Paris (AP-HP), Département de Médecine Interne et Immunologie Clinique, Centre Hospitalier Universitaire de Bicêtre, Le Kremlin-Bicêtre, France
- Ensemble pour une Solidarité Thérapeutique Hospitalière En Réseau (ESTHER), Phnom Penh, Cambodia
| | - Olivier Ségéral
- Assistance Publique - Hôpitaux de Paris (AP-HP), Département de Médecine Interne et Immunologie Clinique, Centre Hospitalier Universitaire de Bicêtre, Le Kremlin-Bicêtre, France
- Ensemble pour une Solidarité Thérapeutique Hospitalière En Réseau (ESTHER), Phnom Penh, Cambodia
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Brooks JI, Niznick H, Ofner M, Merks H, Angel JB. Local phylogenetic analysis identifies distinct trends in transmitted HIV drug resistance: implications for public health interventions. BMC Infect Dis 2013; 13:509. [PMID: 24171696 PMCID: PMC3816547 DOI: 10.1186/1471-2334-13-509] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 10/17/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND HIV transmitted drug resistance (TDR) surveillance is usually conducted by sampling from a large population. However, overall TDR prevalence results may be inaccurate for many individual clinical setting. We analyzed HIV genotypes at a tertiary care setting in Ottawa, Ontario in order to evaluate local TDR patterns among sub-populations. METHOD Genotyping reports were digitized from ART naïve patients followed at the Immunodeficiency Clinic at the Ottawa Hospital, between 2008 and 2010. Quality controlled, digitized sequence data were assessed for TDR using the Stanford HIV Database. Patient characteristics were analyzed according to TDR patterns. Finally, a phylogenetic tree was constructed to elucidate the observed pattern of HIV TDR. RESULTS Among the 155 clinic patients there was no statistically significantly difference in demographics as compared to the Ontario provincial HIV population. The clinic prevalence of TDR was 12.3%; however, in contrast to the data from Ontario, TDR patterns were inverted with a 21% prevalence among MSM and 5.5% among IDU. Furthermore, nearly 80% of the observed TDR was a D67N/K219Q pattern with 87% of these infections arising from a distinct phylogenetic cluster. CONCLUSIONS Local patterns of TDR were distinct to what had been observed provincially. Phylogenetic analysis uncovered a cluster of related infections among MSM that appeared more likely to be recent infections. Results support a paradigm of routine local TDR surveillance to identify the sub-populations under care. Furthermore, the routine application of phylogenetic analysis in the TDR surveillance context provides insights into how best to target prevention strategies; and how to correctly measure outcomes.
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Affiliation(s)
- James I Brooks
- National HIV & Retrovirology Laboratories, Public Health Agency of Canada, Ottawa, Canada.
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Ong LY, Razak SNH, Lee YM, Sri La Sri Ponnampalavanar S, Syed Omar SF, Azwa RI, Tee KK, Kamarulzaman A. Molecular diversity of HIV-1 and surveillance of transmitted drug resistance variants among treatment Naïve patients, 5 years after active introduction of HAART in Kuala Lumpur, Malaysia. J Med Virol 2013; 86:38-44. [PMID: 24127302 DOI: 10.1002/jmv.23772] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2013] [Indexed: 12/14/2022]
Abstract
Expansion of antiretroviral treatment programs have led to the growing concern for the development of antiretroviral drug resistance. The aims were to assess the prevalence of drug resistant HIV-1 variants and to identify circulating subtypes among HAART-naïve patients. Plasma specimens from N = 100 HIV+ HAART-naïve adult were collected between March 2008 and August 2010 and viral RNA were extracted for nested PCR and sequenced. PR-RT sequences were protein aligned and checked for transmitted drug resistance mutations. Phylogenetic reconstruction and recombination analysis were performed to determine the genotypes. Based on the WHO consensus guidelines, none of the recruited patients had any transmitted drug resistance mutations. When analyzed against the Stanford guidelines, 35% of patients had at least one reported mutation that may reduce drug susceptibility to PI (24%), NRTI (5%), and NNRTI (14%). The commonly detected mutation that may affect current first line therapy was V179D (3%), which may lead to reduced susceptibility to NNRTI. The predominant circulating HIV-1 genotypes were CRF01_AE (51%) and CRF33_01B (17%). The prevalence of unique recombinant forms (URF) was 7%; five distinct recombinant structures involving CRF01_AE and subtype B' were observed, among them a cluster of three isolates that could form a novel circulating recombinant form (CRF) candidate. Transmitted drug resistance prevalence among HAART-naïve patients was low in this cohort of patients in Kuala Lumpur despite introduction of HAART 5 years ago. Owing to the high genetic diversity, continued molecular surveillance can identify the persistent emergence of HIV-1 URF and novel CRF with significant epidemiological impact.
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Affiliation(s)
- Lai Yee Ong
- Faculty of Medicine, Centre of Excellence for Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia
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Trinh QD, Pham NTK, Le Nguyen NT, Lam BQ, Le Phan KT, Truong KH, Izumi Y, Komine-Aizawa S, Mizuguchi M, Ushijima H, Hayakawa S. Short communication: Drug resistance mutations in the HIV type 1 protease and reverse transcriptase genes in antiretroviral-naive Vietnamese children. AIDS Res Hum Retroviruses 2012; 28:1305-7. [PMID: 22260721 DOI: 10.1089/aid.2011.0280] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Anti-HIV drugs have recently become available for the treatment of children infected with HIV in Vietnam; however, the genetic background of HIV-1 drug resistance in antiretroviral-naive children has yet to be studied. Of the 104 HIV-1 CRF01-AE subtype strains that were previously isolated from antiretroviral-naive children from the provinces of southern Vietnam and hospitalized in Children Hospital 1 in Ho Chi Minh City from 2004 to 2005, 79 strains were used for amplification and sequence analyses of the protease and reverse transcriptase (RT) genes. Minor mutations were found in the protease gene, including L10I, I13V, G16E, M36I, D60E, I62V, I64V, L63P, H69K, V82I, and I93L. Of these mutations, M36I and H69K were detected in all of the strains that were studied. However, all of the amino acid changes in the protease gene were considered to be polymorphisms. In the RT gene, three major mutations were detected in six strains: the V75M mutation in one strain, the Y181C mutation in two strains, and the M184I mutation in three strains. The prevalence of primary or transmitted HIV drug resistance to all of the drugs and drug classes that were evaluated in this study was 7.6%. These findings provide a useful background for antiretroviral therapy in Vietnam and contribute reference data for the surveillance of HIV drug resistance around the world. This study suggests that the prevalence of HIVDR in Vietnam may have recently increased. The monitoring of HIV drug resistance in Vietnam is necessary.
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Affiliation(s)
- Quang Duy Trinh
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Ngan Thi Kim Pham
- Department of Developmental Medical Sciences, Institute of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Nhut Tin Le Nguyen
- Department of Developmental Medical Sciences, Institute of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | | | | | | | - Yasuyuki Izumi
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Shihoko Komine-Aizawa
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Masashi Mizuguchi
- Department of Developmental Medical Sciences, Institute of International Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Hiroshi Ushijima
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
| | - Satoshi Hayakawa
- Division of Microbiology, Department of Pathology and Microbiology, Nihon University School of Medicine, Tokyo, Japan
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Bontell I, Cuong DD, Agneskog E, Diwan V, Larsson M, Sönnerborg A. Transmitted drug resistance and phylogenetic analysis of HIV CRF01_AE in Northern Vietnam. INFECTION GENETICS AND EVOLUTION 2012; 12:448-52. [PMID: 21620998 DOI: 10.1016/j.meegid.2011.04.034] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2011] [Revised: 04/19/2011] [Accepted: 04/22/2011] [Indexed: 11/24/2022]
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Zolfo M, Schapiro JM, Phan V, Koole O, Thai S, Vekemans M, Fransen K, Lynen L. Genotypic impact of prolonged detectable HIV type 1 RNA viral load after HAART failure in a CRF01_AE-infected cohort. AIDS Res Hum Retroviruses 2011; 27:727-35. [PMID: 20854169 DOI: 10.1089/aid.2010.0037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
HIV subtype-specific data on mutation type, rate, and accumulation following HAART treatment failure are limited. We studied patterns and accrual of drug resistance mutations in a Cambodian CRF01_AE-infected cohort continuing a virologically failing first-line, nonnucleoside reverse transcriptase inhibitor- (NNRTI-) based, HAART. Between 2005 and 2007, 837 adult HIV-infected patients had regular plasma HIV-1 RNA viral load measurements at Sihanouk Hospital Centre of Hope (SHCH), Cambodia. Drug resistance testing was performed in all patients with HIV-1 RNA >1000 copies/ml after at least 6 months of HAART. Seventy-one patients with a mean age of 34 years, of whom 68% were male, were retrospectively assessed at virological failure. The median duration of antiretroviral therapy was 12.3 (IQR 7.1-18.23) months, the median CD4 cell count was 173 (IQR 118-256) cells/mm(3), and the mean plasma HIV-1 RNA viral load was 3.9 log (SD 0.72) at failure. NNRTI mutations, M184I/V mutation, thymidine analogue mutations, and K65R were observed in 78.9%, 69%, 20%, and 12.7% of patients, respectively. For 33 patients, genotypic testing was carried out on at least two occasions before the switch to second-line HAART after a median duration of 5.8 (IQR 4.3-6.1) months of virological failure: 54.5% of patients accumulated new mutations with a rate of 1.6 mutations per person-year. Accumulation was seen both for nucleoside and nonnucleoside reverse transcriptase inhibitors, and also in patients with low-level viremia. Subtype-specific data on mutation type, rate, and accumulation after HAART failure are urgently needed to optimize treatment strategies in resource-limited settings.
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Affiliation(s)
- Maria Zolfo
- Institute of Tropical Medicine, Antwerp, Belgium
| | | | - Vichet Phan
- Sihanouk Hospital Center of HOPE, Phnom Penh, Cambodia
| | | | - Sopheak Thai
- Sihanouk Hospital Center of HOPE, Phnom Penh, Cambodia
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Iarikov DE, Irizarry-Acosta M, Martorell C, Hoffman RP, Skiest DJ. Low prevalence of primary HIV resistance in western Massachusetts. ACTA ACUST UNITED AC 2010; 9:227-31. [PMID: 20798402 DOI: 10.1177/1545109710374998] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Most studies of primary antiretroviral (ARV) resistance have been conducted in large metropolitan areas with reported rates of 8% to 25%. We collected data on 99 HIV-1-infected antiretroviral-naive patients from several sites in Springfield, MA, who underwent genotypic resistance assay between 2004 and 2008. Only major resistance mutations per International AIDS Society-USA (IAS-USA) drug resistance mutations list were considered. The prevalence of resistance was 5% (5 of 99). Three patients had one nonnucleoside reverse transcriptase inhibitor (NNRTI) mutation: 103N, 103N, and 190A, 1 patient had a protease inhibitor (PI) mutation: 90M; and 1 patient had 3-class resistance with NNRTI: 181C, 190A, PI: 90M, and nucleoside analogue reverse transcriptase inhibitor (NRTI): 41L, 210W. Mean time from HIV diagnosis to resistance testing was shorter in patients with resistance versus those without: 9 (range 0.3-42 months) versus 27 (range 0.1-418 months), P = .11. There was a trend to lower mean CD4 count in those with resistance, 170 versus 318 cells/mm(3), P = .06. No differences were noted in gender, age, HIV risk category, or HIV RNA level. The low prevalence of primary resistance may be explained by differences in demographic and risk factors or may reflect the time from infection to resistance testing. Our findings emphasize the importance of continued resistance surveillance.
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Affiliation(s)
- Dmitri E Iarikov
- Division of Infectious Diseases, Baystate Medical Center, Tufts University School of Medicine, Springfield, MA, USA.
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Hattori J, Shiino T, Gatanaga H, Yoshida S, Watanabe D, Minami R, Sadamasu K, Kondo M, Mori H, Ueda M, Tateyama M, Ueda A, Kato S, Ito T, Oie M, Takata N, Hayashida T, Nagashima M, Matsuda M, Ibe S, Ota Y, Sasaki S, Ishigatsubo Y, Tanabe Y, Koga I, Kojima Y, Yamamoto M, Fujita J, Yokomaku Y, Koike T, Shirasaka T, Oka S, Sugiura W. Trends in transmitted drug-resistant HIV-1 and demographic characteristics of newly diagnosed patients: Nationwide surveillance from 2003 to 2008 in Japan. Antiviral Res 2010; 88:72-9. [DOI: 10.1016/j.antiviral.2010.07.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2010] [Revised: 07/12/2010] [Accepted: 07/28/2010] [Indexed: 10/19/2022]
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Bonura F, Tramuto F, Vitale F, Perna AM, Viviano E, Romano N. Transmission of drug-resistant HIV type 1 strains in HAART-naive patients: a 5-year retrospective study in Sicily, Italy. AIDS Res Hum Retroviruses 2010; 26:961-5. [PMID: 20707733 DOI: 10.1089/aid.2009.0250] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The transmission of drug-resistant HIV-1 strains might compromise the efficacy of current first-line antiretroviral (ARV) regimens. Between 2004 and 2008, HIV-1 reverse transcriptase (RT) and protease (PR) genes of 108 ARV-naive Sicilian patients were amplified and sequenced to describe the prevalence of ARV resistance mutations among HAART-naive HIV-1-infected individuals. The frequency of transmitted drug resistance mutations (DRAMs) was determined by using genotypic interpretation algorithms. The proportion of HAART-naive HIV-1-infected patients in Sicily increased from 18.4% to 23.5% during 2004-2008. Among naive patients, the overall prevalence of DRAMs was 15.7% [17/108; 95% CI: 9.4-24.0]. DRAMs to nonnucleoside reverse transcriptase inhibitors (nNRTI) were detected most frequently [11/108 (10.2%)], of which K103N was the most prevalent (4.6%), whereas the prevalence of DRAMs was lowest for protease inhibitors (PI) [3/108 (2.8%)]. Drug resistance substitutions associated with two or three drug classes were rarely observed. The prevalence of HIV-1 DRAMs in Sicily was relatively higher than that observed in Italy and other European geographic areas and much higher than in resource-limited countries. However, the possible clinical role played by DRAMs in HAART-naive HIV-1-infected individuals will require further assessment.
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Affiliation(s)
- Filippa Bonura
- Centro di Riferimento Regionale per la Diagnosi Sierologica e Virologica dell'AIDS, Dipartimento di Scienze per la Promozione della Salute, Università degli Studi di Palermo, Palermo, Italy
| | - Fabio Tramuto
- Centro di Riferimento Regionale per la Diagnosi Sierologica e Virologica dell'AIDS, Dipartimento di Scienze per la Promozione della Salute, Università degli Studi di Palermo, Palermo, Italy
| | - Francesco Vitale
- Centro di Riferimento Regionale per la Diagnosi Sierologica e Virologica dell'AIDS, Dipartimento di Scienze per la Promozione della Salute, Università degli Studi di Palermo, Palermo, Italy
| | - Anna Maria Perna
- Centro di Riferimento Regionale per la Diagnosi Sierologica e Virologica dell'AIDS, Dipartimento di Scienze per la Promozione della Salute, Università degli Studi di Palermo, Palermo, Italy
| | - Enza Viviano
- Centro di Riferimento Regionale per la Diagnosi Sierologica e Virologica dell'AIDS, Dipartimento di Scienze per la Promozione della Salute, Università degli Studi di Palermo, Palermo, Italy
| | - Nino Romano
- Centro di Riferimento Regionale per la Diagnosi Sierologica e Virologica dell'AIDS, Dipartimento di Scienze per la Promozione della Salute, Università degli Studi di Palermo, Palermo, Italy
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Phan TTC, Ishizaki A, Phung DC, Bi X, Oka S, Ichimura H. Characterization of HIV type 1 genotypes and drug resistance mutations among drug-naive HIV type 1-infected patients in Northern Vietnam. AIDS Res Hum Retroviruses 2010; 26:233-5. [PMID: 20156106 DOI: 10.1089/aid.2009.0206] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
To evaluate HIV-1 drug resistance-associated mutations among drug-naive HIV-1-infected patients in Northern Vietnam, we performed sequence analysis of HIV-1 pol-PR and pol-RT in samples collected from 206 (161 men and 45 women) consenting patients in 2008. From these 206 samples, we successfully sequenced 173 pol-PR and 155 pol-RT genes. Phylogenetic analysis revealed that all patients were infected with HIV-1 CRF01_AE. Major protease inhibitor resistance mutations, such as L33F, M46I, and M46L, were found in three patients (1.7%). Major reverse-transcriptase inhibitor (RTI) resistance mutations were found in seven patients (4.5%), four of whom had single mutations: A62V (nucleoside RTI resistance mutation) in two cases and K103N and Y181C (nonnucleoside RTI resistance mutation) in one case each. Three patients had multiple RTI resistance mutations: two, three, and seven, respectively. Thus, monitoring for drug-resistant HIV-1 and performing drug resistance testing before initiating antiretroviral therapy (ART) are recommended to facilitate selection of the appropriate ART and better clinical outcomes in Vietnam.
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Affiliation(s)
- Thi Thu Chung Phan
- Department of Viral Infection and International Health, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan
- Department of Microbiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Azumi Ishizaki
- Department of Viral Infection and International Health, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan
| | - Dac Cam Phung
- Department of Microbiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Xiuqiong Bi
- Department of Viral Infection and International Health, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan
| | - Shinichi Oka
- AIDS Research and Clinical Center, International Medical Center of Japan, Tokyo, Japan
| | - Hiroshi Ichimura
- Department of Viral Infection and International Health, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan
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Ayouba A, Lien TT, Nouhin J, Vergne L, Aghokeng AF, Ngo-Giang-Huong N, Diop H, Kane CT, Valéa D, Rouet F, Joulia-Ekaza D, Toni TD, Nerrienet E, Ngole EM, Delaporte E, Costagliola D, Peeters M, Chaix ML. Low prevalence of HIV type 1 drug resistance mutations in untreated, recently infected patients from Burkina Faso, Côte d'Ivoire, Senegal, Thailand, and Vietnam: the ANRS 12134 study. AIDS Res Hum Retroviruses 2009; 25:1193-6. [PMID: 19886834 DOI: 10.1089/aid.2009.0142] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The frequency of transmitted HIV drug resistance (HIVDR) was evaluated in the context of rapid scale-up of antiretroviral treatment in Thailand, Vietnam, Burkina Faso, Côte d'Ivoire, and Senegal by using an adaptation of the WHO generic protocol of the HIV Drug Resistance Threshold Survey (HIVDR-TS) for sample collection and classification. Resistance-associated mutations were interpreted using the 2009 WHO list for epidemiological surveys. We included 266 subjects from the five study sites. Of the 266 RT and PR sequences analyzed, two from Vietnam harbored virus with major drug resistance mutations (G190A in RT for one individual and M46I in PR for the second individual). Phylogenetic analysis revealed that CRF01_AE predominates (>90%) in Thailand and Vietnam. CRF02 (>65%) cocirculates with other HIV-1 variants in Senegal and Côte d'Ivoire. The prevalence of HIVDRM is scored as low (< or = 5%) in all the five sites for the three drug classes analyzed. A continuous population survey for HIVDRM will provide a rational basis for maintaining or changing the current first line regimen in these countries.
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Affiliation(s)
- Ahidjo Ayouba
- UMR145, IRD and University of Montpellier 1, Montpellier, France
| | | | - Janin Nouhin
- HIV/Hepatitis Laboratory, Institut Pasteur Cambodia, Phnom Penh, Cambodia
| | | | | | | | - Halimatou Diop
- Laboratoire Bacteriologie Virologie, Hôpital le Dantec, Dakar, Senegal
| | - Coumba Touré Kane
- Laboratoire Bacteriologie Virologie, Hôpital le Dantec, Dakar, Senegal
| | | | | | | | | | - Eric Nerrienet
- HIV/Hepatitis Laboratory, Institut Pasteur Cambodia, Phnom Penh, Cambodia
| | | | - Eric Delaporte
- UMR145, IRD and University of Montpellier 1, Montpellier, France
| | | | - Martine Peeters
- UMR145, IRD and University of Montpellier 1, Montpellier, France
| | - Marie-Laure Chaix
- University Paris Descartes, EA 3620, Laboratory of Virology, AP-HP Necker Hospital, Paris, France
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Song JY, Lee JS, Jung HW, Choi HJ, Lee JS, Lee J, Eom JS, Cheong HJ, Jung MH, Kim WJ. Primary Anti-retroviral Resistance in Treatment-naive HIV-infected Patients: A Korean HIV/AIDS Cohort Study. Infect Chemother 2009. [DOI: 10.3947/ic.2009.41.4.230] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Joon Young Song
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Jin Soo Lee
- Division of Infectious Diseases, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Hye Won Jung
- Division of Infectious Diseases, Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea
| | - Hee Jung Choi
- Division of Infectious Diseases, Department of Internal Medicine, Ewha University College of Medicine, Seoul, Korea
| | - Jin Seo Lee
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Jacob Lee
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Joong Shik Eom
- Division of Infectious Diseases, Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Hee Jin Cheong
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
| | - Moon Hyun Jung
- Division of Infectious Diseases, Department of Internal Medicine, Inha University College of Medicine, Incheon, Korea
| | - Woo Joo Kim
- Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
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