HIV-1 drug-resistance mutations among newly diagnosed patients before scaling-up programmes in Burkina Faso and Cameroon.
We analysed whether mutations associated with resistance to antiretroviral (ARV) drugs circulate among treatment-naive HIV-1-infected individuals at a period when these drugs started to become more widely available in Africa. Overall, major resistance mutations in the pol gene, as defined by the International AIDS Society Resistance Testing-USA panel, were observed in 16 treatment-naive individuals. Eight of the 97 patients tested in Burkina Faso bore mutations conferring resistance to one drug class of ARV drugs: two to nucleoside reverse transcriptase inhibitors (NRTIs; M41L [n = 1], M41L+T69S [n = 1]), four to non-NRTIs (NNRTIs; V106A/V [n = 1] and V1081 [n = 3]) and two to protease inhibitors (PIs; L33F [n = 2]). In Cameroon, resistance mutations were identified in 8 of 102 patients: three to PIs (M461/L [n = 2], L33F [n = 1]), three to NRTIs (T69N/T [n = 1], M184V [n = 1], A62V [n = 1]) and two to NNRTIs (P236L [n = 1], V1081 [n = 1]). It is important to note that not all genotypic drug-resistance algorithms give similar interpretations to the observed mutations. Population surveillance for ARV drug resistance is required and should be included in all implementation programmes.
Vergne
Laurence
L
UMR145, Institut de Recherche pour le Développement (IRD) and University of Montpellier, Montpellier, France.
Diagbouga
Serge
S
Kouanfack
Charles
C
Aghokeng
Avelin
A
Butel
Christelle
C
Laurent
Christian
C
Noumssi
Nathalie
N
Tardy
Michêle
M
Sawadogo
Adrien
A
Drabo
Joseph
J
Hien
Hervé
H
Zekeng
Léopold
L
Delaporte
Eric
E
Peeters
Martine
M
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002050:Burkina Faso; D002163:Cameroon; D024921:Drug Resistance, Multiple, Viral / Q000235:genetics*; D005260:Female; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics*; D016333:HIV Protease / Q000235:genetics; D017320:HIV Protease Inhibitors / Q000627:therapeutic use*; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D009313:National Health Programs; D011159:Population Surveillance; D012194:RNA-Directed DNA Polymerase / Q000235:genetics; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*
D017320:HIV Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors; D012194:RNA-Directed DNA Polymerase; D016333:HIV Protease