P17.28 Assessment of hiv-1 primary drug resistance mutations in antiretroviral therapy-naive cases in morocco

Abstract

Antiretroviral drug resistance is a major challenge for management and control of HIV-1 infection worldwide and particularly in resource limited countries. Although combined antiretroviral drug therapy has greatly improved the life-span and the life quality of the patients, HIV-1 drug resistance poses a major obstacle for treatment outcome. This study aims to determine the prevalence of primary resistance in a group of newly diagnosed patients naive to treatment, in the region of Souss Massa Draa in sounthern Morocco. A total of 47 antiretroviral treatment (ART) naive patients were included. Virological status was determined by Real time PCR (Abbott, USA). Primary drug resistance mutations were identified according to the Stanford HIV database and the algorithm of the National Agency for AIDS Research (ANRS). The clinical staging of patients was made upon the International Classification of the Centres for Disease Control (CDC). Ninetheen 19% of recruits were diagnosed in stage A, 11% in stage B, and the large proportion of patients in stage C 38%, while 32% of which the stadium has not been determined. VLs Rates among patients ranged from 5000 to 10 million copies/ml, with a large majority of patients (42.55%) whom VL was estimated from 10 000 and 100 000 copies/ml. Most prevalent HIV-1 subtypes were subtype B (74%); and CRF02_G (26%). Drug resistance exploration showed that 17% of the studied group carry at least one resistant mutation that confers resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs), and 13% have at least one NRTI resistance mutation, while no major resistance mutation was detected for protease inhibitors (IPs). Detected mutations were as follows: M41L, K70E, M184V, L210W and T215C/D/S, responsible for nucleoside RT inhibitor (NRTI) resistance; K103N/S M230L and V106I, responsible for non-nucleoside RT inhibitor (NNRTI) resistance; M46L and L90M, responsible for protease inhibitor (PI) resistance. The primary resistance rate observed in the study group was estimated at 8.5% (4/47). This rate describes the primary resistance level in this region as a moderate level (between 5 and 15%), requiring continuous monitoring of resistance in patients immediately after diagnosis of infection and prior to initiation of treatment antiretroviral. Disclosure of interest statement Nothing to declare.