High resistance to reverse transcriptase inhibitors among persons infected with human immunodeficiency virus type 1 subtype circulating recombinant form 02_AG in Ghana and on antiretroviral therapy.
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Date
2020-02
Journal Title
Journal ISSN
Volume Title
Publisher
Medicine
Abstract
This study sought to determine the dominant circulating human immunodeficiency virus type 1 (HIV-1) subtype and associated drug
resistance mutations in Ghana.
This cross-sectional study was conducted with archived samples collected from patients who received care at 2 hospitals in Ghana
from 2014 to 2016. Blood samples were earlier processed into plasma and peripheral blood mononuclear cells and stored at 80°C.
Ribonucleic acid (RNA) was extracted fromthe archived plasma. Two HIV-1 genes; protease and reverse transcriptase, were amplified,
sequenced using gene-specific primers and analyzed for subtype and drug resistance mutations using the Stanford HIV Database.
Of 16 patient samples successfully sequenced, we identified the predominance of HIV-1 subtype CRF02_AG (11/16, 68%).
Subtypes G (2/16, 13%), dual CRF02_AG/G (2/16, 13%), and CRF01_AE (1/16, 6%) were also observed. Major nucleoside reverse
transcriptase inhibitor (NRTI) resistance mutations, M184I/V, D67N, T215F, and K70R/E were found. Non-nucleoside reverse
transcriptase inhibitor (NNRTI) resistance mutations, K103N, Y181C, V90I, F227L, and V106A were also prevalent. Additionally, and
at a lower level, protease inhibitor (PI)-resistance mutations, M46I, I54V, V82A, L90M, and I471V, were also present in the
sequences from antiretroviral therapy (ART)-experienced individuals. Two NRTI-associated drug resistance mutations (DRMs) (D67N
and T69N) were present in sequences from 1 ART-naive individual.
HIV-1 subtype CRF02_AG was most frequently detected in this study thus confirming earlier reports of dominance of this subtype
in the West-African sub-region and Ghana in particular. The detection of these drug resistance mutations in individuals on first-line
regimen composed of NRTI and NNRTI is an indication of prolonged drug exposure without viral load monitoring. Routine viral load
monitoring is necessary for early detection of virologic failure and drug resistance testing will inform appropriate choice of regimens for
such patients.
Description
Research Article
Keywords
human immunodeficiency virus type 1 (HIV-1), drug resistance, Ghana, Non-nucleoside reverse transcriptase inhibitor (NNRTI
Citation
Deletsu SD, Maina EK, Quaye O, Ampofo WK, Awandare GA, Bonney EY. High resistance to reverse transcriptase inhibitors among persons infected with HIV-1 subtype CRF02_AG in Ghana and on antiretroviral therapy. Medicine. 2020;99:7(e18777).