Molecular Epidemiology of HIV-1 in Ghana: Subtype Distribution, Drug Resistance and Coreceptor Usage
Date
2023
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Viruses
Abstract
The greatest HIV-1 genetic diversity is found in West/Central Africa due to the pandemic’s
origins in this region, but this diversity remains understudied. We characterized HIV-1 subtype
diversity (from both sub-genomic and full-genome viral sequences), drug resistance and coreceptor
usage in 103 predominantly (90%) antiretroviral-naive individuals living with HIV-1 in Ghana. Full genome HIV-1 subtyping confirmed the circulating recombinant form CRF02_AG as the dominant
(53.9%) subtype in the region, with the complex recombinant 06_cpx (4%) present as well. Unique
recombinants, most of which were mosaics containing CRF02_AG and/or 06_cpx, made up 37%
of sequences, while “pure” subtypes were rare (<6%). Pretreatment resistance to at least one drug
class was observed in 17% of the cohort, with NNRTI resistance being the most common (12%) and
INSTI resistance being relatively rare (2%). CXCR4-using HIV-1 sequences were identified in 23% of
participants. Overall, our findings advance our understanding of HIV-1 molecular epidemiology in
Ghana. Extensive HIV-1 genetic diversity in the region appears to be fueling the ongoing creation of
novel recombinants, the majority CRF02_AG-containing, in the region. The relatively high prevalence
of pretreatment NNRTI resistance but low prevalence of INSTI resistance supports the use of INSTI based first-line regimens in Ghana.
Description
Research Article
Keywords
HIV, HIV-1;, subtype diversity, pretreatment drug resistance, Ghana
Citation
Citation: Appah, A.; Beelen, C.J.; Kirkby, D.; Dong, W.; Shahid, A.; Foley, B.; Mensah, M.; Ganu, V.; Puplampu, P.; Amoah, L.E.; et al. Molecular Epidemiology of HIV-1 in Ghana: Subtype Distribution, Drug Resistance and Coreceptor Usage. Viruses 2023, 15, 128. https:// doi.org/10.3390/v15010128