HIV drug resistance pattern among HAART-exposed patients with suboptimal virological response in Ouagadougou, Burkina Faso.
OBJECTIVE
Determine the pattern of drug resistance among HIV infected drug exposed patients failing therapy in Ouagadougou, Burkina Faso.


METHODS
The protease (PR) and reverse transcriptase (RT) of 87 samples from 75 treatment exposed HIV infected patients failing therapy were PCR amplified, sequenced, subtyped and analyzed for the presence of drug resistance mutations.


RESULTS
The most common drugs used were 3TC, AZT (or d4T) and EFV. The dominant subtypes were CRF06_cpx (48%) and CRF02_AG (40%). The prevalence of resistance mutations among patients failing therapy was: PR inhibitors (PI), 40%; non-nucleoside RT-inhibitors (NNRTI), 76% and nucleoside RT-inhibitors (NRTI), 85%. Dominant mutations included M46I (37%), 154V (26%), V82A/T/F (30%) in PR; K103N (44%), G190A/S (16%) and T215F/Y (48%) (NRTIs) in RT. Some resistance mutations, notably D67N/G, K70R and L210W (thymidine analogue mutations-TAMs); K101E, V179E in RT, 154V, V82A/T/F and L90M in PR were significantly higher among CRF06_cpx than CRF02_AG strains (P < 0.05). Although not significant, other TAMs (M41L, T215F/Y, K219Q/E) also occurred more frequently among CRF06_cpx strains as well.


CONCLUSIONS
There is a high prevalence of drug resistance mutations among ARV exposed patients in Burkina Faso with an unexpected subtype-specific difference. Validation of this result will require larger sample sizes and in vitro drug susceptibility studies with CRF06_cpx strains.
Tebit
Denis M
DM
Abteilung Virologie, Universitaetsklinikum Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany.
Sangaré
Lassana
L
Makamtse
Aline
A
Yameogo
Saydou
S
Somlare
Hermann
H
Bado
Guillaume
G
Kouldiaty
Boris G
BG
Sathiandee
Kanokporn
K
Tiba
Fabrice
F
Sanou
Idrissa
I
Ouédraogo-Traoré
Rasmata
R
Zoungrana
Lassané
L
Diallo
Ismael
I
Drabo
Joseph Y
JY
Kräusslich
Hans-Georg
HG
D000293:Adolescent; D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D002050:Burkina Faso / Q000453:epidemiology; D002648:Child; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000188:drug therapy*; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D019562:Viral Load