Dynamic HIV‐1 genetic recombination and genotypic drug resistance among treatment‐experienced adults in northern Ghana. Issue 11 (November 2017)

• Record Type: Journal Article
• Authors: Nii‐Trebi, Nicholas Israel; Brandful, James Ashun Mensah; Ibe, Shiro; Sugiura, Wataru; Barnor, Jacob Samson; Bampoh, Patrick Owiredu; Yamaoka, Shoji; Matano, Tetsuro; Yoshimura, Kazuhisa; Ishikawa, Koichi; Ampofo, William Kwabena
• Is Part Of: Journal of medical microbiology. Volume 66:Issue 11(2017)
• Publication Date: 2017-11
• Subjects: Antiretroviral therapy -- genotypic resistance -- recombinant HIV‐1 -- molecular epidemiology; Medical microbiology -- Periodicals; 616.9041
• DOI: 10.1099/jmm.0.000621
• Languages: English
• ISSNs: 0022-2615

Abstract

Abstract : Purpose. : There have been hardly any reports on the human immunodeficiency virus type 1 (HIV‐1) drug‐resistance profile from northern Ghana since antiretroviral therapy (ART) was introduced over a decade ago. This study investigated prevailing HIV‐1 subtypes and examined the occurrence of drug resistance in ART‐experienced patients in Tamale, the capital of the Northern Region of Ghana. Methodology. : A cross‐sectional study was carried out on HIV‐infected adult patients receiving first‐line ART. HIV viral load (VL) and CD4 + T‐cell counts were measured. The pol gene sequences were analysed for genotypic resistance by an in‐house HIV‐1 drug‐resistance test; the prevailing HIV‐1 subtypes were analysed in detail. Results/Key findings. : A total of 33 subjects were studied. Participants comprised 11 males (33.3%) and 22 (66.7%) females, with a median age of 34.5 years [interquartile range (IQR) 30.0‐40.3]. The median duration on ART was 12 months (IQR 8.0‐24). Of the 24 subjects successfully genotyped, 10 (41.7%) viruses possessed at least one mutation conferring resistance to nucleoside or non‐nucleoside reverse‐transcriptase inhibitors (NRTIs/NNRTIs). Two‐class drug resistance to NRTI and NNRTI was mostly detected (25%, 6/24). The most frequent mutations were lamivudine‐resistance M184V and efavirenz/nevirapine‐resistance K103N. HIV‐1 subtype CRF02_AG was predominant (79.2%). Other HIV‐1 subtypes detected were G (8.3%), A3 (4.2%) and importantly two (8.3%) unique HIV‐1 recombinant forms with CRF02_AG/A3 mosaic. Conclusion. : HIV‐1 shows high genetic diversity and on‐going viral genetic recombination in the study region. Nearly 42% of the patients studied harboured a drug‐resistant virus. The study underscores the need for continued surveillance of HIV‐1 subtype diversity; and of drug‐resistance patterns to guide selection of second‐line regimens in northern Ghana.