899
Survey of HIV-1 Drug-resistance Mutations in Recently Infected, Antiretroviral-naïve Patients from Sub-Saharan Africa and Southeast Asia
Ahidjo Ayouba*1, E Nerrienet2, L Truong Xuan3, L Vergne1, E Mpoudi Ngole4, D Valea5, N Ngo-Giang-Huong6, D Costagliola7, M Peeters1, M L Chaix8, and ANRS 12134 Study Group
1Inst for Res and Devt, UMR145, Montpellier, France; 2Inst Pasteur, Phnom Penh, Cambodge; 3Inst Pasteur, Ho Chi Minh City, Vietnam; 4CRESAR/IRD/IMPM, Yaounde, Cameroon; 5Ctr Muraz, Bobo Dioulasso, Burkina Faso; 6Chiang Mai Univ, Thailand; 7INSERM U720, Paris, France; and 8Ctr Hosp Univ Necker, Paris, France
Background: Universal access to antiretroviral
therapy in developing countries has raised concerns that HIV drug resistance
could develop and spread quickly in recently infected people. We evaluated the
frequency of transmitted HIV drug resistance in 3 Southeast Asian (Cambodia,
Thailand, and Vietnam) and 2 African (Burkina Faso and Cameroon) countries.
Methods: The target population, in which a
relatively high proportion of recently infected persons is likely to appear,
was adapted to the characteristics of the HIV epidemic in each country. Using
binomial sequential sampling, as many as 47 consecutively collected eligible
specimens are needed to classify presence of drug resistant strains (for each
drug or drug class) as <5%, 5 to 15%, and >15%. HIV-1 genotypic
resistance tests were performed on plasma samples and phylogenetic analysis was
performed based on protease and reverse transcriptase (RT) sequences.
Resistance associated mutations were interpreted with the 2007 Stanford HIVdb
algorithm, International AIDS Society (IAS) -USA list and the French national
AIDS trial group (ANRS) algorithm.
Results: As recommended by the generic protocol for
HIV-1 drug resistance developed by WHO-HIVRESNET, pregnant women aged 15 to 24
years at first pregnancy were enrolled in Cameroon. In Burkina Faso and
Thailand, pregnant women were also included but, in addition to age and number
of pregnancies, CD4 count >500/mm3 was added as marker for recent
infection. In Cambodia and Vietnam, individuals attending Voluntary Counseling
and Testing (VCT) centers were included based on age and CD4 counts. Overall, 4
individuals harbored virus with drug-resistance mutations, 1 in Cameroon
(K103N), 1 in Cambodia (K101KQ+K103N+M184V), and 2 in Vietnam (G190A and M46I).
Phylogenetic analysis revealed that CRF01_AE predominates (>90%) in
Cambodia, Thailand, and Vietnam. CRF02 (>60%) co-circulates with many other
HIV-1 variants in Cameroon and with CRF06 in Burkina Faso.
|
|
 |
Conclusions: Prevalence of HIV-1 drug-resistance
mutations among recently infected individuals was low in our study. However,
the upper limit of the confidence intervals suggest that population size could
be increased for future surveys. Population survey for antiretroviral drug
resistance will provide important public data in resource-limited countries.
|
