title: Transmitted antiretroviral drug resistance in newly HIV-infected and untreated patients in Ségou and Bamako, Mali.
abstract: The WHO recommends regular surveillance for transmitted antiretroviral drug-resistant viruses in HIV antiretroviral treatment (ART)-naive patients in resource-limited settings. This study aimed to assess the prevalence of mutations associated with resistance in ART-naive patients newly diagnosed with HIV in Bamako and Ségou in Mali. HIV-positive patients who never received ART were recruited in Bamako and Ségou, Mali. The reverse transcriptase (RT) and protease (PR) genes of these patients were sequenced by the "ViroSeq" method. Analysis and interpretation of the resistance were made according to the WHO 2009 list of drug resistance mutations. In all, 51/54 (94.4%) sample patients were sequenced. The median age (IQR) of our patients was 24 (22-27) years and the median CD4 count was 380 (340-456) cells/mm(3). The predominant subtype was recombinant HIV-1 CRF02_AG (66.7%) followed by CRF06_cpx (12%) and CRF09_cpx (4%). Four patients had mutations associated with resistance, giving an overall prevalence of resistance estimated at 7.9%. There were two (4%) patients with nucleoside reverse transcriptase inhibitor (NRTI) mutations (one M184V and one T215Y), two (4%) with non-NRTI mutations (two K103N), and one (2%) with a protease inhibitor mutation (one I54V). The prevalence of primary resistance in newly infected patients in Mali is moderate (7.9%). This indicates that the standard NNRTI-based first-line regimen used in Mali is suboptimal for some patients. This study should be done regularly to inform clinical practice.
authors: Unite d'Epidemiologie Moleculaire de la Resistance du VIH aux ARV, SEREFO, FMPOS, Universite des Sciences Techniques et des Technologies de Bamako, USTTB, Bamako, Mali. amaiga@icermali.org
authors: Almoustapha Issiaka
authors: AI
authors: Maiga
authors: Djeneba Bocar
authors: DB
authors: Fofana
authors: Aichatou Chehy
authors: AC
authors: Maiga
authors: Fodie
authors: F
authors: Diallo
authors: Zaina
authors: Z
authors: Ait-Arkoub
authors: Fatoumata
authors: F
authors: Daou
authors: Mamadou
authors: M
authors: Cisse
authors: Yaya Dit Sadio
authors: YD
authors: Sarro
authors: Aboubacar Alassane
authors: AA
authors: Oumar
authors: Aliou
authors: A
authors: Sylla
authors: Christine
authors: C
authors: Katlama
authors: Babafemi
authors: B
authors: Taiwo
authors: Robert
authors: R
authors: Murphy
authors: Anatole
authors: A
authors: Tounkara
authors: Anne-Genevieve
authors: AG
authors: Marcelin
authors: Vincent
authors: V
authors: Calvez
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018791:CD4 Lymphocyte Count; D024882:Drug Resistance, Viral / Q000235:genetics; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000635:transmission*; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics*; D006801:Humans; D008297:Male; D008302:Mali / Q000453:epidemiology; D009154:Mutation; D015995:Prevalence; D017421:Sequence Analysis; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents