title: Drug resistance mutations and genetic diversity in adults treated for HIV type 1 infection in Mauritania.
abstract: The aim of this cross-sectional study was to evaluate the drug resistance mutationprofile observed in patients receiving antiretroviral therapy with virological failure and to document the HIV-1 genetic diversity in Mauritania. Eighty-six subjects were included and 65 samples were amplified successfully and sequenced. HIV-1 genotyping was performed using the Agence Nationale de Recherche sur le SIDA AC11 resistance procedure. The median treatment duration was 32 months (range: 6-88) and the median viral load, 5 log10 copies/ml (range: 3.13-7). Fifty-nine patients (90.8%) were on first line regimens including 32.0% (19/59) on triomune fixed-dose and six on second-line therapy with NonNucleoside Reverse Transcriptase plus a protease inhibitor. Forty-seven patients (72.3%) had at least one drug resistance mutation including 73.0% (43/59) on first-line therapy. For the second-line, one out of six patients presented resistance mutations and only one presented PI DRM. Overall, the most common DRMs detected were M184V/I (n = 32; 49.2%), K103N (n = 28; 43%), and Y181C (n = 13; 20%). Thymidine Analog Mutations (TAMs) were found in 26.0% (n = 17) of strains and the most common was T215Y (n = 11, 16.9%). Phylogenetic analysis revealed 17 HIV-1 variants with the predominance of CRF02_AG (n = 42; 64.6%). A high rate of DRM was found in this study and shows the potential need for a structured virological surveillance including viral load quantification and genotyping. Further studies may also be needed in regards to the great variability of HIV-1 strains in Mauritania.
authors: Laboratory of Virology, Public Health National Institute (INRSP), Nouakchott, Mauritania.
authors: F-Zahra
authors: FZ
authors: Fall-Malick
authors: Edmond
authors: E
authors: Tchiakpé
authors: Sid'Ahmed
authors: S
authors: Ould Soufiane
authors: Halimatou
authors: H
authors: Diop-Ndiaye
authors: Abderrahmane
authors: A
authors: Mouhamedoune Baye
authors: Abdallah
authors: A
authors: Ould Horma Babana
authors: Coumba
authors: C
authors: Touré Kane
authors: Baidy
authors: B
authors: Lo
authors: Souleymane
authors: S
authors: Mboup
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D024882:Drug Resistance, Viral; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D060005:Genotyping Techniques; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology*; D015497:HIV-1 / Q000145:classification / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008435:Mauritania; D008875:Middle Aged; D020125:Mutation, Missense; D010802:Phylogeny; D016133:Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D013997:Time Factors; D019562:Viral Load; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: HIV-1; Mauritania; genetic diversity; therapeutic failure