title: HIV-1 pol diversity among female bar and hotel workers in Northern Tanzania.
abstract: A national ART program was launched in Tanzania in October 2004. Due to the existence of multiple HIV-1 subtypes and recombinant viruses co-circulating in Tanzania, it is important to monitor rates of drug resistance. The present study determined the prevalence of HIV-1 drug resistance mutations among ART-naive female bar and hotel workers, a high-risk population for HIV-1 infection in Moshi, Tanzania. A partial HIV-1 pol gene was analyzed by single-genome amplification and sequencing in 45 subjects (622 pol sequences total; median number of sequences per subject, 13; IQR 5-20) in samples collected in 2005. The prevalence of HIV-1 subtypes A1, C, and D, and inter-subtype recombinant viruses, was 36%, 29%, 9% and 27%, respectively. Thirteen different recombination patterns included D/A1/D, C/A1, A1/C/A1, A1/U/A1, C/U/A1, C/A1, U/D/U, D/A1/D, A1/C, A1/C, A2/C/A2, CRF10_CD/C/CRF10_CD and CRF35_AD/A1/CRF35_AD. CRF35_AD was identified in Tanzania for the first time. All recombinant viruses in this study were unique, suggesting ongoing recombination processes among circulating HIV-1 variants. The prevalence of multiple infections in this population was 16% (n = 7). Primary HIV-1 drug resistance mutations to RT inhibitors were identified in three (7%) subjects (K65R plus Y181C; N60D; and V106M). In some subjects, polymorphisms were observed at the RT positions 41, 69, 75, 98, 101, 179, 190, and 215. Secondary mutations associated with NNRTIs were observed at the RT positions 90 (7%) and 138 (6%). In the protease gene, three subjects (7%) had M46I/L mutations. All subjects in this study had HIV-1 subtype-specific natural polymorphisms at positions 36, 69, 89 and 93 that are associated with drug resistance in HIV-1 subtype B. These results suggested that HIV-1 drug resistance mutations and natural polymorphisms existed in this population before the initiation of the national ART program. With increasing use of ARV, these results highlight the importance of drug resistance monitoring in Tanzania.
authors.affiliation: Kilimanjaro Christian Medical Centre and College, Tumaini University, Moshi, Tanzania; Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Ireen E
authors.initials: IE
authors.lastname: Kiwelu
authors.affiliation: Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Novitsky
authors.affiliation: Kilimanjaro Christian Medical Centre and College, Tumaini University, Moshi, Tanzania; Kilimanjaro Reproductive Health Program, Moshi, Tanzania.
authors.forename: Elimsaada
authors.initials: E
authors.lastname: Kituma
authors.affiliation: Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Lauren
authors.initials: L
authors.lastname: Margolin
authors.affiliation: Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Jeannie
authors.initials: J
authors.lastname: Baca
authors.affiliation: Kilimanjaro Christian Medical Centre and College, Tumaini University, Moshi, Tanzania; Kilimanjaro Reproductive Health Program, Moshi, Tanzania.
authors.forename: Rachel
authors.initials: R
authors.lastname: Manongi
authors.affiliation: Kilimanjaro Christian Medical Centre and College, Tumaini University, Moshi, Tanzania; Kilimanjaro Reproductive Health Program, Moshi, Tanzania.
authors.forename: Noel
authors.initials: N
authors.lastname: Sam
authors.affiliation: Kilimanjaro Christian Medical Centre and College, Tumaini University, Moshi, Tanzania.
authors.forename: John
authors.initials: J
authors.lastname: Shao
authors.affiliation: Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: Mary F
authors.initials: MF
authors.lastname: McLane
authors.affiliation: London School of Hygiene and Tropical Medicine, London, United Kingdom; Kilimanjaro Reproductive Health Program, Moshi, Tanzania.
authors.forename: Saidi H
authors.initials: SH
authors.lastname: Kapiga
authors.affiliation: Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, Massachusetts, United States of America.
authors.forename: M
authors.initials: M
authors.lastname: Essex
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000494:pharmacology* / Q000627:therapeutic use; D004252:DNA Mutational Analysis; D024882:Drug Resistance, Viral; D005260:Female; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology*; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D008969:Molecular Sequence Data; D009154:Mutation; D010802:Phylogeny; D011110:Polymorphism, Genetic; D011446:Prospective Studies; D013636:Tanzania; D054302:pol Gene Products, Human Immunodeficiency Virus / Q000235:genetics*
chemical_list: D019380:Anti-HIV Agents; D054302:pol Gene Products, Human Immunodeficiency Virus