Molecular diversity and polymerase gene genotypes of HIV-1 among treatment-naïve Cameroonian subjects with advanced disease.
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.
Soares
Esmeralda A
EA
Instituto Nacional de Câncer, Rio de Janeiro, Brazil.
Makamche
Marie Florence
MF
Siqueira
Juliana D
JD
Lumngwena
Evelyn
E
Mbuagbaw
Josephine
J
Kaptue
Lazare
L
Asonganyi
Tazoacha
T
Seuánez
Héctor N
HN
Soares
Marcelo A
MA
Alemnji
George
G
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*
D012367:RNA, Viral; D054302:pol Gene Products, Human Immunodeficiency Virus