Evolution of genetic diversity and drug resistance mutations in HIV-1 among untreated patients from Mali between 2005 and 2006
Evolution of genetic diversity and drug resistance mutations in HIV-1 among untreated patients from Mali between 2005 and 2006
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DOI：
10.1093/jac/dkn234
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发表时间：
2008-09-01
影响因子：
5.2
通讯作者：
Marcelin, Anne-Genevieve
中科院分区：
文献类型：
--
作者：
Derache, Anne;Maiga, Almoustapha-Issiaka;Marcelin, Anne-Genevieve
目的：描述在马里流行的HIV-1变异，并估计2006年HIV-1耐药性的传播率。患者和方法：对2006年5月在巴马科和塞古被诊断为HIV-1阳性的198例抗逆转录病毒（ARV）患者的病毒逆转录酶（RT）和蛋白酶（PR）基因进行了测序。结果：虽然CRF02_AG一直是HIV-1的主要亚型（72%），但其遗传多样性高于2005年。根据2007年IAS-USA突变列表[核苷RT抑制剂（NRTI）： 1.5%，非NRTI (NNRTI): 9%， PI: 1%]和斯坦福突变列表（NRTI: 1%, NNRTI: 1.5%, PI: 0%）， 2006年马里原发性耐药的总体患病率为11.5%。在2005年和2006年之间，不同抗逆转录病毒药物类别的总体原发性耐药流行率或突变流行率没有显著差异。在RT和PR基因中发现的耐药突变与马里现有的高活性抗逆转录病毒治疗方案一致，但V90I、V106I和A98G突变除外，这些突变与曲曲维碱耐药有关，但在非b亚型中存在多态性。结论：HIV-1基因多样性在马里似乎有所增加，但总体HIV-1原发性耐药性患病率仍然很低。这与患病率低于5%的其他西非国家的调查结果一致。然而，考虑到该国抗逆转录病毒药物使用的大规模扩大，有必要定期监测马里初级耐药性的发展。
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.