title: HIV drug resistance pattern among HAART-exposed patients with suboptimal virological response in Ouagadougou, Burkina Faso.
abstract: 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.
authors.affiliation: Abteilung Virologie, Universitaetsklinikum Heidelberg, Im Neuenheimer Feld 324, 69120 Heidelberg, Germany.
authors.forename: Denis M
authors.initials: DM
authors.lastname: Tebit
authors.forename: Lassana
authors.initials: L
authors.lastname: Sangaré
authors.forename: Aline
authors.initials: A
authors.lastname: Makamtse
authors.forename: Saydou
authors.initials: S
authors.lastname: Yameogo
authors.forename: Hermann
authors.initials: H
authors.lastname: Somlare
authors.forename: Guillaume
authors.initials: G
authors.lastname: Bado
authors.forename: Boris G
authors.initials: BG
authors.lastname: Kouldiaty
authors.forename: Kanokporn
authors.initials: K
authors.lastname: Sathiandee
authors.forename: Fabrice
authors.initials: F
authors.lastname: Tiba
authors.forename: Idrissa
authors.initials: I
authors.lastname: Sanou
authors.forename: Rasmata
authors.initials: R
authors.lastname: Ouédraogo-Traoré
authors.forename: Lassané
authors.initials: L
authors.lastname: Zoungrana
authors.forename: Ismael
authors.initials: I
authors.lastname: Diallo
authors.forename: Joseph Y
authors.initials: JY
authors.lastname: Drabo
authors.forename: Hans-Georg
authors.initials: HG
authors.lastname: Kräusslich
mesh_terms: 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