title: Prevalence of Transmitted Drug Resistance Mutations in HIV-1-Infected Drug-Naive Patients from Urban and Suburban Regions of Kenya.
abstract: HIV was first described in Kenya in 1984-1985. Currently, Kenya has an estimated HIV-1 prevalence of 6.2%. With the introduction of antiretroviral drugs, the survival of most HIV patients has been prolonged markedly. However, this is greatly threatened by increasing rates of antiretroviral dug resistance, which may eventually lead to suboptimal treatment outcomes. The objective of this study was to characterize currently occurring antiretroviral drug resistance mutations among drug-naive patients visiting two referral hospitals in Kenya. Using polymerase chain reaction, the HIV protease gene was amplified from blood samples of 63 study participants. The sequences were used to determine HIV-1 subtype and presence/prevalence of mutations associated with resistance to protease inhibitors. Finally, the protease gene was variably measured using Shannon entropy analysis. Analysis of frequency of HIV-1 subtypes revealed subtype A to be the predominant subtype, while the analysis of drug resistance mutations revealed the presence of four minor drug resistance mutations associated weakly with resistance to protease inhibitors. Among these mutations, L33I was the most prevalent mutation. Shannon entropy analysis revealed high genomic variability, especially in region spanning nucleotides 1-55, 113-170, and 205-240. This study warrants the need for dedicated efforts to improve compliance to antiretroviral therapy and reduce transmitted resistance rates, which will greatly ensure the therapeutic efficacy of antiretroviral drugs.
authors.affiliation: 1 Aga Khan University Hospital , Nairobi, Kenya .
authors.forename: Simon
authors.initials: S
authors.lastname: Onsongo
authors.affiliation: 2 Department of Biological and Biomedical Sciences, Aga Khan University , Karachi, Pakistan .
authors.forename: Syed Hani
authors.initials: SH
authors.lastname: Abidi
authors.affiliation: 3 U.S. Military HIV Research Program, Henry M. Jackson Foundation Medical Research International , Mbeya, Tanzania .
authors.forename: Samoel
authors.initials: S
authors.lastname: Khamadi
authors.affiliation: 1 Aga Khan University Hospital , Nairobi, Kenya .
authors.forename: Reena
authors.initials: R
authors.lastname: Shah
authors.affiliation: 4 Kenya Medical Research Institute , Nairobi, Kenya .
authors.forename: Sheila
authors.initials: S
authors.lastname: Kageha
authors.affiliation: 1 Aga Khan University Hospital , Nairobi, Kenya .
authors.forename: Peter
authors.initials: P
authors.lastname: Ojwang
authors.affiliation: 5 Department of Biomedical Sciences, Nazarbayer School of Medicine, Nazarbayer University, Astana, Kazakstan.
authors.forename: Syed
authors.initials: S
authors.lastname: Ali
authors.affiliation: 1 Aga Khan University Hospital , Nairobi, Kenya .
authors.forename: Nancy
authors.initials: N
authors.lastname: Okinda
mesh_terms: D000328:Adult; D000368:Aged; D024882:Drug Resistance, Viral; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology; D016333:HIV Protease / Q000235:genetics; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D006801:Humans; D007630:Kenya / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D020125:Mutation, Missense; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011446:Prospective Studies; D017422:Sequence Analysis, DNA; D013383:Suburban Population; D014505:Urban Population; D055815:Young Adult
chemical_list: D016333:HIV Protease; C514803:p16 protease, Human immunodeficiency virus 1