title: Genetic diversity and drug resistance mutations in HIV type 1 from untreated patients in Bamako, Mali.
abstract: OBJECTIVE
  To determine the genetic diversity of HIV-1 reverse transcriptase (RT) and protease sequences and the presence of mutations linked to antiretroviral (ARV) resistance in treatment-naive, HIV-1-infected individuals living in Mali.
  
  
  METHODS
  Ninety-eight samples from ARV drug-naive, HIV-1-infected patients were collected in one clinical centre in Bamako, Mali in 2005. RT and protease genes were sequenced in order to perform phylogenetic and resistance analyses.
  
  
  RESULTS
  The most prevalent subtype was CRF02-AG (75% of cases), followed by the CRF06-cpx subtype (20%). Intersubtype recombinants between CRF02-AG, CRF01-AE and CRF06-cpx were also described in 5% of cases. After 4 years of ARV use in Mali, two previously untreated individuals (2%; 95% CI: 0.00-4.77%) were found to have resistant viruses, one with a single nucleoside mutation and one with K103N non-nucleoside reverse transcriptase inhibitor resistance mutation. No evidence of transmitted protease inhibitor resistance mutations was found.
  
  
  CONCLUSIONS
  These data provide direct evidence for the circulation of HIV-1 isolates containing resistance mutations in treatment-naive patients in Mali. Since ARV use in Mali began, more than 5000 patients have started treatment, mostly with Triomune (stavudine/lamivudine/nevirapine). The resistance-associated mutations detected in the present study are consistent with this treatment regimen. Continued surveillance will be required to monitor the emergence of ARV resistance in this country.
authors.affiliation: Department of Virology, Pitié-Salpêtrière Hospital, AP-HP, EA 2387, Universitè Pierre et Marie Curie, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Derache
authors.forename: Ousmane
authors.initials: O
authors.lastname: Traore
authors.forename: Victoria
authors.initials: V
authors.lastname: Koita
authors.forename: Aliou
authors.initials: A
authors.lastname: Sylla
authors.forename: Roland
authors.initials: R
authors.lastname: Tubiana
authors.forename: Anne
authors.initials: A
authors.lastname: Simon
authors.forename: Ana
authors.initials: A
authors.lastname: Canestri
authors.forename: Guislaine
authors.initials: G
authors.lastname: Carcelain
authors.forename: Christine
authors.initials: C
authors.lastname: Katlama
authors.forename: Vincent
authors.initials: V
authors.lastname: Calvez
authors.forename: Mamadou
authors.initials: M
authors.lastname: Cisse
authors.forename: Anne-Geneviève
authors.initials: AG
authors.lastname: Marcelin
mesh_terms: D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use*; D024882:Drug Resistance, Viral / Q000235:genetics*; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D015658:HIV Infections / Q000097:blood / Q000188:drug therapy / Q000235:genetics* / Q000821:virology; D016333:HIV Protease / Q000235:genetics; D054303:HIV Reverse Transcriptase / Q000235:genetics; D015497:HIV-1 / Q000201:enzymology / Q000235:genetics*; D006801:Humans; D008297:Male; D008302:Mali; D008875:Middle Aged; D009154:Mutation; D010802:Phylogeny; D012367:RNA, Viral / Q000097:blood*
chemical_list: D044966:Anti-Retroviral Agents; D012367:RNA, Viral; D054303:HIV Reverse Transcriptase; D016333:HIV Protease