title: HIV-1 genetic diversity and drug resistance among Senegalese patients in the public health system.
abstract: In this study, we investigated the prevalence of human immunodeficiency virus type 1 (HIV-1) drug resistance mutations and genetic variability among Senegalese patients undergoing highly active antiretroviral therapy (ART) in the public health system. We conducted a cross-sectional study of 72 patients with suspected therapeutic failure. HIV-1 genotyping was performed with Viroseq HIV-1 Genotyping System v2.0 or the procedure developed by the ANRS AC11 resistance study group, and a phylogenetic analysis was performed. The median follow-up visit was at 40 (range, 12 to 123) months, and the median viral load was 4.67 (range, 3.13 to 6.94) log(10) copies/ml. The first-line therapeutic regimen was nucleoside reverse transcriptase inhibitors (NRTIs) plus efavirenz (EFV) or NRTIs plus nevirapine (NVP) (54/72 patients; 75%), and the second-line therapy was NRTIs plus a protease inhibitor (PI/r) (18/72; 25%). Fifty-five patients (55/72; 76.39%) had at least one drug resistance mutation. The drug resistance rates were 72.22 and 88.89% for the first-line and second-line ARTs, respectively. In NRTI mutations, thymidine analog mutations (TAMs) were found in 50.79% and the M184V mutation was found in 34.92% of the samples. For non-NRTI resistance, we noted a predominance of the K103N mutation (46.27%). For PI/r, several cases of mutations were found with a predominance of M46I and L76V/F at 24% each. The phylogenetic analysis revealed CRF02_AG as the predominant circulating recombinant form (43/72; 59.72%). We found a high prevalence of resistance mutations and a high rate of TAMs among Senegalese patients in the public health system. These findings emphasize the need to improve virological monitoring in resource-limited settings.
authors.affiliation: Laboratoire de Bactériologie-Virologie, Hôpital Le Dantec, Dakar, Senegal.
authors.forename: Moussa
authors.initials: M
authors.lastname: Thiam
authors.forename: Halimatou
authors.initials: H
authors.lastname: Diop-Ndiaye
authors.forename: Aminata Diaw
authors.initials: AD
authors.lastname: Diouf
authors.forename: Nicole
authors.initials: N
authors.lastname: Vidal
authors.forename: Ousseynou
authors.initials: O
authors.lastname: Ndiaye
authors.forename: Ibrahima
authors.initials: I
authors.lastname: Ndiaye
authors.forename: Ndeye Fatou
authors.initials: NF
authors.lastname: Ngom-Gueye
authors.forename: Sada
authors.initials: S
authors.lastname: Diallo
authors.forename: Oumy Diop
authors.initials: OD
authors.lastname: Diongue
authors.forename: Makhtar
authors.initials: M
authors.lastname: Camara
authors.forename: Abdoulaye
authors.initials: A
authors.lastname: Seck
authors.forename: Souleymane
authors.initials: S
authors.lastname: Mboup
authors.forename: Coumba
authors.initials: C
authors.lastname: Toure-Kane
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology*; D003430:Cross-Sectional Studies; D024882:Drug Resistance, Viral / Q000235:genetics; D005260:Female; D014644:Genetic Variation; D016679:Genome, Viral; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology; D015497:HIV-1 / Q000145:classification / Q000187:drug effects* / Q000235:genetics*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D008969:Molecular Sequence Data; D009154:Mutation; D010802:Phylogeny; D011634:Public Health; D012675:Senegal; D019562:Viral Load; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents