JAC Advance Access published online on June 13, 2008
Journal of Antimicrobial Chemotherapy, doi:10.1093/jac/dkn234
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Original research |
Evolution of genetic diversity and drug resistance mutations in HIV-1 among untreated patients from Mali between 2005 and 2006
1 UPMC Univ Paris 06, EA2387, 4 Place Jussieu, F-75005 Paris, France 2 Department of Virology, 83 Boulevard de l'Hôpital, AP-HP Pitie Salpetriere Hospital, F-75013 Paris, France 3 SOLTHIS, 58A rue du Dessous des Berges, F-75013 Paris, France 4 CESAC, B.P. E 2561, Bamako, Mali 5 SOLTHIS, B.P. E 529, Segou, Mali 6 Hospital of Lagny, 31 avenue du Général Leclerc, F-77405 Lagny sur Marne, France 7 Department of Immunology, 83 Boulevard de l'Hôpital, AP-HP Pitie Salpetriere Hospital, F-75013 Paris, France 8 Department of Virology, Bretonneau Hospital, 2 Boulevard Tonnellé, F-37044 Tours, France 9 Department of Infectious Diseases, 47 Boulevard de l'Hôpital, AP-HP Pitie Salpetriere Hospital, F-75013 Paris, France
Received 24 January 2008; returned 6 March 2008; revised 13 May 2008; accepted 19 May 2008
* Correspondence address. Department of Virology, Pitie Salpetriere Hospital, 83 Boulevard de l'Hôpital, 75013 Paris, France. Tel: +33-14217-7401; Fax: +33-14217-7411; E-mail: anne-genevieve.marcelin{at}psl.aphp.fr
Objectives: To describe HIV-1 variants circulating in Mali and to estimate the rate of transmission of HIV-1 drug resistance in 2006.
Patients and methods: Viral reverse transcriptase (RT) and protease (PR) genes from 198 antiretroviral (ARV)-naive patients diagnosed HIV-1 positive in May 2006 in Bamako and Segou were sequenced.
Results: Although CRF02_AG was always the predominant HIV-1 subtype observed (72%), a higher genetic diversity than that in 2005 was observed. The overall prevalence of primary resistance is 11.5% in Mali in 2006, according to the 2007 IAS-USA list of mutations [nucleoside RT inhibitor (NRTI): 1.5%, non-NRTI (NNRTI): 9% and PI: 1%], and 2.5% (NRTI: 1%, NNRTI: 1.5% and PI: 0%), according to the Stanford list of mutations. There was no significant difference between 2005 and 2006 in the overall primary resistance prevalence or in the prevalence of mutations in the different ARV classes. Resistance mutations found in RT and PR genes are in agreement with the highly active antiretroviral therapy regimen available in Mali, except for V90I, V106I and A98G mutations which are associated with etravirine resistance, but polymorphic in non-B subtypes.
Conclusions: HIV-1 genetic diversity seems increased in Mali, but the overall HIV-1 primary resistance prevalence remains low. This is consistent with the findings from other West African countries where prevalence rates are lower than 5%. However, considering the large scaling up of ARV use in this country, it is necessary to regularly monitor the development of primary resistance in Mali.
Key Words: antiretroviral drugs , primary resistance , HIV subtype , Africa