title: Variability of the human immunodeficiency virus type 1 polymerase gene from treatment naïve patients in Accra, Ghana.
abstract: BACKGROUND
  Little is known about the HIV-1 drug resistance mutations in Ghana.
  
  
  OBJECTIVE
  To determine the background protease (PR) and reverse transcriptase (RT) mutations of HIV-1 from treatment naïve patients in Ghana.
  
  
  METHODS
  Twenty-five plasma samples randomly selected were analyzed for drug resistance mutations. The molecular phylogeny and recombinant patterns of the polymerase gene of HIV-1 were also analysed.
  
  
  RESULTS
  No major drug-resistance mutations were seen in protease or reverse transcriptase genes. The L10I, L10V, V11I and E35G minor mutations were seen in four patients, while the V179E was observed in a patient with subtype G. An insertion of lysine was found at codon 36 of the protease gene of one patient. The predominant subtype was the CRF02_AG strain (n=22), but 3 (13.6%) of these were recombinants with HIV-1 subtype K and/or A1. Two patients harboured unclassified/complex strains with D/CRF01_AE and G/CRFAG_02 subtypes for the PR and RT, respectively, using the Stanford Database. Viral loads (VL) ranged from 2290 to >1,500,000c/ml (mean=339,065c/ml).
  
  
  CONCLUSIONS
  Treatment naïve patients in Ghana before scale-up may have minor but not major PR mutations and high viral loads. The clinical effects of minor mutations/polymorphisms in the PR and RT genes and recombinants need to be investigated.
authors.affiliation: Clinical Virology Laboratory (Department of Microbiology), University of Ghana Medical School, Accra, Ghana. kwcsagoe@chs.edu.ug
authors.forename: Kwamena William Coleman
authors.initials: KW
authors.lastname: Sagoe
authors.forename: Magdar
authors.initials: M
authors.lastname: Dwidar
authors.forename: Margaret
authors.initials: M
authors.lastname: Lartey
authors.forename: Isaac
authors.initials: I
authors.lastname: Boamah
authors.forename: Afrakoma Adjoa
authors.initials: AA
authors.lastname: Agyei
authors.forename: Anna Aba
authors.initials: AA
authors.lastname: Hayford
authors.forename: Julius Abraham Addo
authors.initials: JA
authors.lastname: Mingle
authors.forename: Max Q
authors.initials: MQ
authors.lastname: Arens
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology*; D024882:Drug Resistance, Viral; D005814:Genes, Viral; D014644:Genetic Variation; D005869:Ghana; D015658:HIV Infections / Q000821:virology*; D016333:HIV Protease / Q000235:genetics; D054303:HIV Reverse Transcriptase / Q000235:genetics; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics*; D006801:Humans; D008875:Middle Aged; D009154:Mutation; D010802:Phylogeny; D011897:Random Allocation