Abstract
Monitoring genetic diversity and drug resistance mutations (DRMs) is critical for understanding HIV epidemiology. Here, we report HIV-1 genetic diversity and DRMs in blood samples from 42 HIV-positive pregnant women naive to antiretroviral therapy (ART), in Luanda. The samples were subjected to nested-PCR, followed by sequencing of HIV-1 pol gene, targeting the protease and reverse transcriptase fragments. HIV-1 diversity was analyzed using the REGA HIV-1 subtyping tool and DRMs were identified using the Calibrated Population Resistance tool. A total of 34 sequences were obtained. The data revealed wide HIV-1 subtypes heterogeneity, with subtype C (38%, 13/34) the most frequent, followed by the subtypes F1 (18%, 6/34), A1 (9%, 3/34), G (9%, 3/34), D (6%, 2/34) and H (3%, 1/34). In addition, recombinants strains were detected, with CRF02_AG (6%, 2/34) the most frequent, followed by CRF37_cpx, F1/C, A1/G and H/G, all with 3% (1/34). A total of 6/34 (18%) of the sequences presented DRMs. The non-nucleoside reverse transcriptase inhibitors presented 15% (5/34) of resistance. Moreover, 1/34 (3%) sequence presented resistance against both non-nucleoside reverse transcriptase inhibitors and nucleoside reverse transcriptase inhibitors, simultaneously. Despite the small sample size, our results suggest the need to update currently used ART regimens. Surveillance of HIV-1 subtypes and DRMs are necessary to understand HIV epidemiology and to guide modification of ART guidelines in Angola.
Highlights
The human immunodeficiency virus (HIV) has become a major global public health problem [1], affecting about 36.9 million people in the world [2]
The first-line of the antiretroviral therapy (ART) drugs used in Angola includes the nucleoside reverse transcriptase inhibitors (NRTIs), tenofovir (TDF) and lamivudine (3TC), and a non-nucleoside reverse transcriptase inhibitor (NNRTI), either efavirenz (EFV) or nevirapine (NVP) [13,14]
From the 1612 pregnant women tested for HIV, 42 (2.6%) tested positive and not been exposed to any ART previously
Summary
The human immunodeficiency virus (HIV) has become a major global public health problem [1], affecting about 36.9 million people in the world [2]. HIV is classified into types (HIV-1 and HIV-2), groups (M, N, O and P), subtypes (A-D, F-H, J and K), sub-subtypes (A1, A2, F1 and F2), circulating recombinant forms (CRFs) and unique recombinant forms (URFs) [3]. All subtypes of HIV-1 group M (except B), several CRFs and URFs have been described in Angola [5,6,7,8,9,10,11]. The first-line of the ART drugs used in Angola includes the nucleoside reverse transcriptase inhibitors (NRTIs), tenofovir (TDF) and lamivudine (3TC), and a non-nucleoside reverse transcriptase inhibitor (NNRTI), either efavirenz (EFV) or nevirapine (NVP) [13,14]. Zidovudine (AZT) has been used to prevent vertical transmission [13,14]
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