title: The prevalence of resistance-associated mutations to protease and reverse transcriptase inhibitors in treatment-naïve (HIV1)-infected individuals in Casablanca, Morocco.
abstract: BACKGROUND
  The widespread use of antiretroviral agents and the growing occurrence of HIV-1 strains resistant to these drugs have given rise to serious concerns regarding the transmission of resistant viruses to newly infected persons, which may reduce the efficacy of a first-line antiretroviral therapy.
  
  
  METHODS
  RNA was extracted from plasma samples of 98 treatment-naïve individuals with a plasma HIV RNA viral load of at least 1,000 copies/ml. Both protease (pr) and reverse transcriptase (rt) were amplified and sequenced using an automated sequencer. National Agency for AIDS Research (ANRS) and Stanford HIV database algorithms were used for interpretation of resistance data.
  
  
  RESULTS
  In the protease segment, various minor mutations were present in the majority of the sequenced samples with high frequencies. Only two major mutations, M46L and V82L, were separately found in three individuals of 71 (4.2%) with one carrying both mutations. In the reverse transcriptase gene, no NNRTIs-associated resistance mutations were detected. Only one patient of 70 (1.4%) carried the F77L mutation that is associated with NRTIs resistance. Genetic subtyping revealed that 74.6% of samples were infected with subtype B, 15.5% with CRF02_AG, 4.2% with CRF01_AE, 1.4% with C, 2.8% with G and 1.4% with subtype F2.
  
  
  CONCLUSIONS
  The low prevalence of major mutations associated with resistance to antiretroviral drugs (ARVs) among drug-naïve individuals studied suggests that the routine of drug resistance testing may be unnecessary for all Moroccan individuals newly diagnosed or all patients beginning antiretroviral therapy. Nevertheless, continuous surveillance is required since greater access to antiretroviral drugs is expected in Morocco.
authors.affiliation: Laboratoire de Virologie, Institut Pasteur du Maroc, 1 Place Louis Pasteur, 20100 Casablanca, Morocco. bakhouch.khadija@yahoo.com
authors.forename: Khadija
authors.initials: K
authors.lastname: Bakhouch
authors.forename: Ahd
authors.initials: A
authors.lastname: Oulad-Lahcen
authors.forename: Rajae
authors.initials: R
authors.lastname: Bensghir
authors.forename: Mohamed
authors.initials: M
authors.lastname: Blaghen
authors.forename: Kamal Marhoum
authors.initials: KM
authors.lastname: Elfilali
authors.forename: Sayeh
authors.initials: S
authors.lastname: Ezzikouri
authors.forename: Omar
authors.initials: O
authors.lastname: Abidi
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hassar
authors.forename: Lahcen
authors.initials: L
authors.lastname: Wakrim
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000821:virology; D016333:HIV Protease / Q000235:genetics*; D017320:HIV Protease Inhibitors / Q000494:pharmacology*; D054303:HIV Reverse Transcriptase / Q000235:genetics*; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009018:Morocco; D020125:Mutation, Missense; D010936:Plant Extracts; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000235:genetics / Q000302:isolation & purification; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology*; D017422:Sequence Analysis, DNA; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D010936:Plant Extracts; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors; C015378:nas; D054303:HIV Reverse Transcriptase; D016333:HIV Protease