HIV type 1 subtype diversity and drug resistance among HIV type 1-infected Kenyan patients initiating antiretroviral therapy
| Autor: | Joyceline Kinyua, Fredrick A. Okoth, Samoel Khamadi, Nancy Lagat, Elijah M. Songok, Kizito Lubano, Raphael Lwembe, Raphael W. Lihana, Ernest P. Makokha, Michael Kiptoo, Hiroshi Ichimura |
|---|---|
| Rok vydání: | 2009 |
| Předmět: |
Adult
CD4-Positive T-Lymphocytes Male medicine.medical_specialty Genotype Immunology Population Molecular Sequence Data HIV Infections Drug resistance Genes env Acquired immunodeficiency syndrome (AIDS) Virology Internal medicine Antiretroviral Therapy Highly Active Drug Resistance Viral Medicine Humans education Phylogeny education.field_of_study Reverse-transcriptase inhibitor Base Sequence business.industry Genetic Variation Middle Aged Viral Load Resistance mutation medicine.disease Genes pol Kenya CD4 Lymphocyte Count Multiple drug resistance Infectious Diseases Mutation HIV-1 Reverse Transcriptase Inhibitors Female business Viral load medicine.drug |
| Zdroj: | AIDS research and human retroviruses. 25(12) |
| ISSN: | 1931-8405 |
| Popis: | The treatment of HIV-1 infection with antiretroviral drugs has greatly improved the survival of those who are infected. However, HIV-1 diversity and drug resistance are major challenges in patient management, especially in resource-poor countries. To evaluate HIV-1 genetic diversity and drug resistance-associated mutations among drug-naive patients in Kenya prior to antiretroviral therapy (ART), a genetic analysis of HIV-1 pol-RT and env-gp41 was performed on samples collected from 53 (18 males and 35 females) consenting patients between April and June 2005. The average age, baseline CD4(+) T cell counts, and viral loads were 38 (range, 24-62) years, 475 (range, 203-799) cells/mm(3), and 4.7 (range, 3.4-5.9) log(10) copies/ml, respectively. Phylogenetic analysis revealed that 40 samples (75.5%) were concordant subtypes for the two genes and 13 (24.5%) were discordant, suggesting possible recombination and/or dual infections. Prevalent subtypes included A1/A1(pol-RT/env-gp41), 31 (58.5%); D/D, 9 (16.9%); A1/C, 2 (3.8%); A1/D, 4 (7.5%); G/A1, 2 (3.8%); A1/A2, 1 (1.9%); C/A1, 2 (3.8%); D/A1, 1(1.9%); and D/A2, 1 (1.9%). Major reverse transcriptase inhibitor (RTI) resistance-associated mutations were found in four patients (7.5%). Of these patients, three had nucleoside RTI resistance mutations, such as M184V, K65R, D67N, K70R, and K219Q. Nonnucleoside RTI resistance-associated mutations K103N and Y181C were detected in three patients and one patient, respectively. Multiple drug resistance mutations were observed in this drug-naive population. With increasing numbers of patients that require treatment and the rapid upscaling of ART in Kenya, HIV-1 drug resistance testing is recommended before starting treatment in order to achieve better clinical outcomes. |
| Databáze: | OpenAIRE |
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