Abstract
Background: The introduction of antiretroviral (ARV) in resource-limited settings has increased life expectancy among non-B HIV-1 infected individuals. We used a validated In-house genotyping assay to characterize non-B HIV-1 and to determine drug resistance mutations among treatment-naive patients. Methods: Plasma samples from 105 HIV-1 infected drug-naive adult patients attending a tertiary hospital Jos, Nigeria were subjected to HIV-1 RNA extraction, reverse transcription amplification, and population-based sequencing of the partial pol gene on the ABI 3130xl genetic analyzer. Subtyping and phylogenetic analyses were performed by REGA Subtyping Tool v2.0 and MEGA v5.0 respectively. Drug resistance profiles were evaluated according to IAS-USA 2013 drug resistance mutations list. Result: One hundred samples (95.2%) were successfully genotyped. The distribution of the non-B HIV-1 subtypes were; CRF02_AG-48%, G-41.0%, CRF06_cpx-6.0%, and A-5.0%. Ten percent of the isolates had at least one major drug resistance mutation in the pol gene. The drug-class specific resistance prevalences were 6.0% for NRTIs; M41L-1.0%, K65KR-1.0%, M184IM-1.0%, M184V-2.0%, and T215ADNT-1%, 8.0% for NNRTIs; K103N-2%, 1.0% for K101E, E138A, G190A, P225HP, Y181I, Y188L, Y181C including protease inhibitors’ Q58E (1.0%). Conclusion: HIV-1 was heterogeneously distributed; CRF02_AG and G predominate and some known major mutations associated with NRTIs and NNRTIs were determined. The In-house assay is suitable for both characterization of non-B HIV-1 subtypes and detection of drug resistance at a significant lower cost than available commercial genotyping assays. This finding underscores the need to consider use of low-cost In-house genotyping assay as an alternative in resource-limited settings with non-B HIV-1 epidemic.
Highlights
Human Immunodeficiency Virus type 1 (HIV-1) is responsible for chronic infection leading to Acquired Immunodeficiency Syndrome (AIDS) as a result of chronic infection damage [1]
HIV-1 was heterogeneously distributed; CRF02_AG and G predominate and some known major mutations associated with NRTIs and NNRTIs were determined
The In-house assay is suitable for both characterization of non-B HIV-1 subtypes and detection of drug resistance at a significant lower cost than available commercial genotyping assays
Summary
Human Immunodeficiency Virus type 1 (HIV-1) is responsible for chronic infection leading to Acquired Immunodeficiency Syndrome (AIDS) as a result of chronic infection damage [1]. The presence of some viral mutations introduced into the HIV-1 genome during replication can compromise efficacy, while others display susceptibility of the virus infectivity in combination with ARVs resistance. With this expected long-term and success of ART in developing countries, the coverage and programmatic effort should be complemented by HIV drug resistance (HIVDR) monitoring programs to ensure good clinical outcomes, and to reduce treatment failure and transmission of drug resistance [4]. In-house genotypic drug resistance testing has been successfully used in developed countries; for surveillance and monitoring of drug resistance in HIV infected individuals receiving ART, but has not been integrated into the continuum of care in most settings in Africa. The drug-class specific resistance prevalences were 6.0% for NRTIs; M41L-1.0%, K65KR-1.0%, M184IM-1.0%, M184V-2.0%, and T215ADNT-1%, 8.0% for NNRTIs; K103N-2%, 1.0% for K101E, E138A, G190A, P225HP, Y181I, Y188L, Y181C including protease inhibitors’ Q58E
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