title: Pitfalls of antiretroviral drug resistance genotyping of HIV-1 Group M and Group N from Cameroon by sequenced-based assays.
abstract: BACKGROUND
  HIV-1 genotyping for antiretroviral drug resistance mutations (DRMs) were developed based basically on subtype B HIV-1 Group M, which represents only 10% of HIV strains worldwide. In sub-Saharan Africa, non-B subtypes HIV-1 largely predominate and HIV-1 genetic diversity could affect the performance of drug resistance genotyping assays. We compared prospectively the performance of the ViroSeq(®) and Trugene(®) genotyping assays to detect DRM in HIV-1-infected adult patients living in Douala, Cameroun.
  
  
  METHODS
  DRM in protease (P) and reverse transcriptase (RT) genes were assessed in parallel using both ViroSeq(®) and Trugene(®) assays in plasma samples from 45 first-line antiretroviral treatment-experienced patients in Douala, Cameroon.
  
  
  RESULTS
  Trugene HIV-1 Genotyping Assay(®) (Siemens Health Care Diagnostics, NY, USA) and ViroSeq HIV-1 Genotyping System(®)(Celera Diagnostics, CA, USA) assessed equivalently antiretroviral DRMs in P and RT genes from non-B HIV-1 Group M in 44 Cameroonian adults in virological failure; Trugene(®) was slightly more sensitive than ViroSeq(®) (100% vs. 91%). One patient infected by HIV-1 Group N was successfully amplified only by the Trugene HIV-1 Genotyping assay(®), while ViroSeq HIV-1 Genotyping System v2.0(®) assay could not.
  
  
  CONCLUSIONS
  Results showed the higher performance of the Trugene(®) system to detected and amplify P and RT genes targeting DRM to the principal antiretroviral drugs used in sub-Saharan Africa. Discrepancies between the results of HIV viral load assays and molecular tests should alert clinicians and virologists to the possibility of infection by an atypical variant virus, especially in Central Africa where very broad HIV-1 genetic diversity exists.
authors.affiliation: Department of Biological Science and Bio Med Research Centre, University of Quebec at Montreal (UQAM), Montreal, QC, Canada.
authors.forename: Mohammad-Ali
authors.initials: MA
authors.lastname: Jenabian
authors.affiliation: Laboratory of Bio-Medical Analysis Litto-Labo, Douala, Cameroon.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Talla
authors.affiliation: Laboratory of Bio-Medical Analysis Litto-Labo, Douala, Cameroon.
authors.forename: Perrine
authors.initials: P
authors.lastname: Talla
authors.affiliation: Department of Laboratories and Blood Safety, Ministry of Public Health and University of Yaounde I, Yaounde, Cameroon.
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Mbopi-Kéou
authors.affiliation: IAME, UMR 1137, University of Paris Diderot, Sorbonne Paris Cité, and Bichat-Claude Bernard Hospital, Virology Laboratory, Paris, France.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Charpentier
authors.affiliation: Bacteriology and Virology Laboratory, CHU Aristide Le Dantec, Dakar, Senegal.
authors.forename: Coumba Toure
authors.initials: CT
authors.lastname: Kane
authors.affiliation: Faculty of Medicine, Paris Descartes University Paris Descartes (Paris V), Sorbonne Paris Cité, Paris and Georges Pompidou European Hospital, Paris, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Bélec
keywords: Cameroon; Central Africa; HIV-1 Group N; Trugene® HIV-1 Genotyping assay; ViroSeq® HIV-1 Genotyping System v2.0; non-B subtypes HIV-1 Group M