Antiretroviral drug resistance in HIV-1 infected patients receiving antiretroviral treatment in routine clinics in Cotonou, Benin

Abstract

A cross-sectional survey was conducted in 2008 to examine virological outcome and emergence of drug resistance in HIV-infected patients treated according to the national guidelines in an AIDS clinic in Cotonou, Benin. Median time on (antiretroviral therapy) ART of the 122 enrolled patients was 35 months. Viral load above 1,000 copies/ml was observed in 33 patients (27%) and 22.1% (27/122) harbored resistant strains: viruses from four, fifteen and eight patients were resistant to one, two and three drugs in their treatment regimen. The most frequent mutations were M184V and K103N in the reverse transcriptase gene. The proportion of patients with drug resistant mutations did not increase with time on ART. There seems to be a trend towards a lower prevalence of drug resistance mutations in patients who started with protease inhibitors-based regimens as compared to (Non-Nucleoside Reverse Transcriptase Inhibitor) NNRTI-based regimens. Further studies are necessary to evaluate if in the absence of laboratory monitoring, the use of PIs for the first-line ART should be reconsidered to minimize the risk of emergence of HIV drug resistance. Key words: HIV, resistance, protease inhibitors, African countries, public health approach.