Genotypic Characterization Of HIV-1 From Patients In Two Regions Of Ghana

Abstract

The HIV/AIDS pandemic is still a global health issue despite the many concerted efforts put in by various stakeholders to curtail it. It has become clear however that understanding the epidemiology of the highly variant virus is key in eliminating it. It has been shown that the subtype of infecting HIV-1 plays a crucial role in disease progression among other thing. It is therefore important to continually monitor the circulating HIV-1 subtypes in the population. Equally important, is the need to monitor the occurrence of drug resistance mutations in the population. With the continuous increase in the prevalence of drug resistance HIV-1 strains, it is key to be aware of the prevalence of drug resistance in the population in order to combat it. This study aims to determine the common circulating HIV-1 subtype and to identify the drug resistance mutations present, if any, in the sampled population. Viral RNA was extracted from sixty-three (63) archival plasma samples collected from four groups of HIV-1 patients in a previous study. The HIV protease and Reverse Transcriptase genes were amplified by polymerase chain reaction and positive amplification products sequenced and analysed to determine the subtype and to identify drug resistance mutations. The protease and reverse transcriptase genes were successfully amplified from 46% and 33% of samples respectively. From these, 27.6% and 69.1% were successfully sequenced for the protease and reverse transcriptase genes respectively. All (100%) of the protease subtypes were CRF02_AG. Of the reverse transcriptase subtypes, 77% were CRF02_AG, 13% G and 10% were CRF01_AE subtype. Drug resistance mutations were identified in 37.5% of protease sequences and 53.9% of reverse transcriptase sequences. The most prevalent NRTI mutation was the M184I which translated to a high frequency of lamivudine resistant samples. About 85.7% of reverse transcriptase sequences were resistant to both NNRTIs (Nevirapine and Efavirenz) in use in Ghana. This study provides evidence that the CRF02_AG is the common circulating subtype in the sampled population and indicate the presence of high frequency of resistance to Nevirapine and Efavirenz.