Abstract
Introduction: Despite the success derived from antiretroviral therapy, drug resistance (DR) mutations are known to develop and are major impediments to treatment of HIV patients. Therefore, periodic assessment of HIVDR is needed to ensure continuous HAART efficacy. This study assessed the magnitude of drug resistance as well as HIV genetic variability in drug-naive and treated patients in Nigeria. Methodology: Genotypic analysis was performed by sequencing plasma specimens from 40 individuals in a cross sectional study involving 202 HIV infected patients from all the six geopolitical zones of Nigeria. Sequences were analyzed for presence of HIVDR mutation using the algorithm in Stanford HIVDR database and confirmed by IAS-USA 2009 mutation list. Phylogenetic and recombination analyses were done using PAUP V4.0 and REGA V2.0 respectively. Results: Major DR mutations were detected in the reverse transcriptase (RT) gene of 5 (33%) drug experienced and 2 (8%) na?ve patients. Most common mutations were M184V and K103N with no protease (PR) mutations detected. Thymidine analogue mutations (TAMs) and a complex multi resistance mutation Q151M were detected in 3 samples. Polymorphic substitutions were observed in both PR and RT gene. Phylogenetic analysis revealed Group M isolates of G (20), J (1), circulating recombinant forms: CRF02_AG (14), CRF-18-cpx (1), CRF06_cpx (3) and a unique AD recombinant (1). Conclusion: Our findings corroborate previous studies on circulating DR viruses in Nigeria while genetic diversity is on the increase. In view of ART scale-up, monitoring the resistance pattern and genetic diversity will aid in appropriate prevention strategies.
Highlights
Despite the success derived from antiretroviral therapy, drug resistance (DR) mutations are known to develop and are major impediments to treatment of HIV patients
Reduced susceptibility to ARVs has been reported in non-B subtypes than in subtype B, and that genetic differences among subtypes could result in differential patterns of resistant mutations in response to ARV pressure [9]
We evaluated antiretroviral drug resistant among HIV-infected ARTtreated and naïve patients and further assessed the circulating HIV-1 variants in Nigeria
Summary
Despite the success derived from antiretroviral therapy, drug resistance (DR) mutations are known to develop and are major impediments to treatment of HIV patients. This study assessed the magnitude of drug resistance as well as HIV genetic variability in drug-naïve and treated patients in Nigeria. Results: Major DR mutations were detected in the reverse transcriptase (RT) gene of 5 (33%) drug experienced and 2 (8%) naïve patients. Antiretroviral drugs were developed based on subtype-B isolates and had successfully reduced the incidence of opportunistic infections and HIV related morbidity and mortality [4]. Reduced susceptibility to ARVs has been reported in non-B subtypes than in subtype B, and that genetic differences among subtypes could result in differential patterns of resistant mutations in response to ARV pressure [9]. Most data on HIV-1 drug resistance mechanisms are from subtype-B viruses due to availability of genotypic and phenotypic antiretroviral drug resistance testing in the western world
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