Prevalence of HIV type-1 drug-associated mutations in pre-therapy patients in the Free State, South Africa
Prevalence of HIV type-1 drug-associated mutations in pre-therapy patients in the Free State, South Africa
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DOI：
10.3851/imp1416
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发表时间：
2009-01-01
影响因子：
1.2
通讯作者：
Frater, John
中科院分区：
文献类型：
--
作者：
Huang, Kuan-Hsiang Gary;Goedhals, Dominique;Frater, John
背景资料：我们的目的是在南非自由州省启动高效抗逆转录病毒治疗（HAART）之前，描述HIV-1的分子流行病学特征和药物相关突变的患病率。自由州有300万人口，产前艾滋病毒感染率约为34%，并建立了基础设施抗逆转录病毒（ARV）provision.Methods：HIV-1聚合酶基因测序425 HAART初治HIV-1阳性患者在自愿初级保健HIV检测中心，谁随后参加区中心开始ARV的评估。患者（>18岁）随机抽样，不排除性别或临床标准。序列进行了分析，根据同源性和耐药性。结果：在队列内的系统发育聚类提示多个引进的C亚型病毒进入该地区。耐药突变（根据国际艾滋病协会-美国分类）随机分布在队列遗传学中，抽样患者的总体患病率为2.3%。当根据CD 4（+）T细胞计数分层时，CD 4（+）T细胞计数500个细胞/μ l的耐药患病率分别为3.6%、0.9%和1.2%，并且最常见的是非核苷逆转录酶抑制剂耐药（CD 4（+）T细胞计数500个细胞/μ l的患者中为3.1
Background: We aimed to characterize the molecular epidemiology of HIV type-1 (HIV-1) and the prevalence of drug-associated mutations prior to initiating highly active antiretroviral therapy (HAART) in the Free State province, South Africa. The Free State has a population of 3 million, an antenatal HIV prevalence of approximately 34% and a well established infrastucture for antiretroviral (ARV) provision.Methods: HIV-1 polymerase genes were sequenced from 425 HAART-naive HIV-1-positive patients at voluntary primary healthcare HIV testing centres, who were subsequently attending district centres for assessment for commencing ARVs. Patients (>18 years) were sampled randomly with no exclusion for gender or clinical criteria. Sequences were analysed according to phylogeny and drug resistance.Results: Phylogenetic clustering within the cohort was suggestive of multiple introductions of subtype C virus into the region. Drug resistance mutations (according to the International AIDS Society-USA classification) were distributed randomly across the cohort phylogeny with an overall prevalence of 2.3% in the sampled patients. When stratified according to CD4(+) T-cell count, the prevalence of resistance was 3.6%, 0.9% and 1.2% for CD4(+) T-cell counts 500 cells/mu l, respectively, and was most common for non-nucleoside reverse transcriptase inhibitor resistance (3.1% in patients with CD4(+) T-cell count