title: Low level of transmitted HIV Drug resistance at two HIV care centres in Ghana: a threshold survey.
abstract: BACKGROUND
  As access to antiretroviral therapy (ART) increases, the emergence and transmission of HIV drug resistant strains becomes a major problem. The World Health Organization (WHO) therefore recommends an initial minimum-resource method to signal when transmitted HIV drug resistance (HIVDR) requires action.
  
  
  OBJECTIVE
  This survey sought to generate information on the presence of HIV drug-resistant strains in the locality where Ghana's ART for HIV was first introduced.
  
  
  METHODS
  The Ghana HIVDR threshold survey (TS) was conducted and analyzed according to WHO strategy for surveillance of HIVDR in the Eastern Region of Ghana. Sixty (60) plasma specimens were collected from 2007 to 2009 by an unlinked anonymous method from HIV seropositive pregnant women, aged between 15 to24 years, who were with their first pregnancy and ART naive. Genotyping was done as follows; Ribonucleic acid (RNA) was extracted from the samples and the protease (PR) and reverse transcriptase (RT) genes amplified and sequenced. The sequences were then analyzed for HIV drug resistance mutations using Stanford University HIV Drug Resistance Database.
  
  
  RESULTS
  Only two individuals were found with major HIVDR mutations: one each in the PR and RT genes. Thus the level of HIVDR in the study population in 2009 was classified as low (< 5%).
  
  
  CONCLUSIONS
  As at February 2009, transmitted drug resistance was not a serious problem in the Eastern Region of Ghana. However, it is important to continue monitoring tHIVDR in order to understand the dynamics of the evolution of HIV drug resistance in the country.
authors: Virology Dept, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana.
authors: E Y
authors: EY
authors: Bonney
authors: N A
authors: NA
authors: Addo
authors: N A A
authors: NA
authors: Ntim
authors: F
authors: F
authors: Addo-Yobo
authors: P
authors: P
authors: Bondzie
authors: K-E
authors: KE
authors: Aryee
authors: J
authors: J
authors: Barnor
authors: J
authors: J
authors: Brandful
authors: V
authors: V
authors: Bekoe
authors: S-A
authors: SA
authors: Ohene
authors: W
authors: W
authors: Ampofo
mesh_terms: D000293:Adolescent; D000328:Adult; D044966:Anti-Retroviral Agents / Q000627:therapeutic use; D004252:DNA Mutational Analysis; D024882:Drug Resistance, Viral / Q000235:genetics*; D005260:Female; D005838:Genotype; D005869:Ghana / Q000453:epidemiology; D016333:HIV Protease / Q000235:genetics; D054303:HIV Reverse Transcriptase / Q000235:genetics; D006679:HIV Seropositivity / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission* / Q000821:virology; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D009154:Mutation; D009313:National Health Programs; D011247:Pregnancy; D015995:Prevalence; D018571:Sentinel Surveillance; D055815:Young Adult
chemical_list: D044966:Anti-Retroviral Agents; D054303:HIV Reverse Transcriptase; D016333:HIV Protease
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