Performance of drug-resistance genotypic assays among HIV-1 infected patients with predominantly CRF02_AG strains of HIV-1 in Abidjan, Cote d'Ivoire.

Abstract Objective: We evaluated the performance of three genotypic assays to detect resistant mutations among HIV-1 infected patients with known antiretroviral drug resistance profile in Abidjan, Cote d’Ivoire, most of whom had the circulating recombinant form (CRF02_A/G) of HIV-1. Methods: The 56 patients analyzed in this study were enrolled in a pilot program to make available antiretroviral therapy (ART) to HIV-infected patients in Abidjan through the UNAIDS Drug Access Initiative (DAI). These patients had failed ART, as demonstrated by rebound in RNA viral load. Their plasma samples had been previously analyzed for ART genotypic drug-resistance by VircoGEN™ (Mechelen, Belgium) and were known to have primary and secondary resistance mutations, and also had phenotypic drug-resistance by a recombinant virus assay technology (Mechelen, Belgium). The two assays we evaluated were: VircoGEN™, TruGene™ HIV-1, and ViroSEQ HIV-1 assays. Results: For the reverse transcriptase gene, all 27 samples that had the T215Y/F mutation were detected by VircoGEN™, ViroSEQ, and TrueGene™. All 19 (100%) samples that had the K70R/E mutation detected by VircoGEN™ were detected by ViroSEQ, and 18 (94.7%) by TrueGene™. All ten samples with the M184V mutation, three with the K65R, two with the G190A mutation, one with the K103N mutation, and one with the V75T mutation were detected similarly by all three assays. For the protease gene, all three assays detected the I84V ( n = 1), M46I ( n = 1), and L90M ( n = 1) mutations. Conclusion: These results suggest that any of these assays should be considered for monitoring the occurrence of drug resistance among HIV-infected patients receiving antiretroviral therapy in West Africa.