title: Molecular diversity and polymerase gene genotypes of HIV-1 among treatment-naïve Cameroonian subjects with advanced disease.
abstract: BACKGROUND
  The progress of antiretroviral treatment roll-out programs in developing countries requires extensive monitoring of primary drug resistance prior to initiation of therapy. This is particularly relevant for Cameroon where a high HIV diversity has been reported.
  
  
  OBJECTIVE
  To determine HIV diversity in Yaoundé, Cameroon, in a cohort of HIV-infected subjects with advanced disease. To characterize HIV-1 mutations conferring primary drug resistance and to assess primary resistance patterns in the RNase H domain of the reverse transcriptase of these viruses.
  
  
  METHODS
  HIV-1 RNA was extracted from plasma of 59 HIV-1 infected, drug-naïve subjects with CD4+ T-cell counts<200/microl. HIV-1 pol (PR, RT and RNase H) regions were sequenced for subtyping and for identifying drug resistance mutations in pol (PR, RT and RNase H).
  
  
  RESULTS
  A complex HIV-1 diversity was seen, with multiple subtypes (A1, A2, C, D, F2, H, group O), CRFs (02_AG, 09_cpx, 11_cpx, 13_cpx, 22_01A1, 30_0206, 43_02G) and URFs. Primary drug resistance was low in PR (2%) and in RT regions (4%). RNase H mutations Q509L and Q547K were found in non-CRF02_AG strains.
  
  
  CONCLUSIONS
  A high HIV-1 diversity was already present in Cameroon in the early 90s, when the subjects were likely infected. Primary HIV-1 drug resistance was low. Occurrence of RNase H mutations with proven phenotypic effect on susceptibility to antiretrovirals encourages further assessment of their impact in treatment outcome in the context of complex HIV genetic diversity and in a subtype-specific fashion.
authors.affiliation: Instituto Nacional de Câncer, Rio de Janeiro, Brazil.
authors.forename: Esmeralda A
authors.initials: EA
authors.lastname: Soares
authors.forename: Marie Florence
authors.initials: MF
authors.lastname: Makamche
authors.forename: Juliana D
authors.initials: JD
authors.lastname: Siqueira
authors.forename: Evelyn
authors.initials: E
authors.lastname: Lumngwena
authors.forename: Josephine
authors.initials: J
authors.lastname: Mbuagbaw
authors.forename: Lazare
authors.initials: L
authors.lastname: Kaptue
authors.forename: Tazoacha
authors.initials: T
authors.lastname: Asonganyi
authors.forename: Héctor N
authors.initials: HN
authors.lastname: Seuánez
authors.forename: Marcelo A
authors.initials: MA
authors.lastname: Soares
authors.forename: George
authors.initials: G
authors.lastname: Alemnji
mesh_terms: D000328:Adult; D019943:Amino Acid Substitution / Q000235:genetics; D002163:Cameroon / Q000453:epidemiology; D016000:Cluster Analysis; D024882:Drug Resistance, Viral; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology*; D015497:HIV-1 / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D017720:Molecular Epidemiology; D008969:Molecular Sequence Data; D020125:Mutation, Missense; D011110:Polymorphism, Genetic; D012367:RNA, Viral / Q000097:blood / Q000302:isolation & purification; D017422:Sequence Analysis, DNA; D054302:pol Gene Products, Human Immunodeficiency Virus / Q000235:genetics*
chemical_list: D012367:RNA, Viral; D054302:pol Gene Products, Human Immunodeficiency Virus