Antiretroviral-Drug Resistant Mutations and Genetic Diversity in HIV-1 Infected Individuals in Nigeria
2014
Introduction: Despite
the success derived from antiretroviral therapy, drug resistance (DR) mutations
are known to develop and are major impediments to treatment of HIV patients. Therefore,
periodic assessment of HIVDR is needed to ensure continuous HAART efficacy. This
study assessed the magnitude of drug resistance as well as HIV genetic
variability in drug-naive and treated patients in Nigeria. Methodology:
Genotypic analysis was performed by sequencing plasma specimens from 40
individuals in a cross sectional study involving 202 HIV infected patients from
all the six geopolitical zones of Nigeria. Sequences were analyzed for presence
of HIVDR mutation using the algorithm in Stanford HIVDR database and confirmed
by IAS-USA 2009 mutation list. Phylogenetic and recombination analyses were
done using PAUP V4.0 and REGA V2.0 respectively. Results: Major DR mutations
were detected in the reverse transcriptase (RT) gene of 5 (33%) drug
experienced and 2 (8%) na?ve patients. Most common mutations were M184V and
K103N with no protease (PR) mutations detected. Thymidine analogue mutations
(TAMs) and a complex multi resistance mutation Q151M were detected in 3 samples.
Polymorphic substitutions were observed in both PR and RT gene. Phylogenetic
analysis revealed Group M isolates of G (20), J (1), circulating recombinant
forms: CRF02_AG (14), CRF-18-cpx (1), CRF06_cpx (3) and a unique AD recombinant
(1). Conclusion: Our findings corroborate previous studies on circulating DR
viruses in Nigeria while genetic diversity is on the increase. In view of ART
scale-up, monitoring the resistance pattern and genetic diversity will aid in
appropriate prevention strategies.
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