Prevalence of Antiretroviral Drug Resistance Mutations and HIV-1 Subtypes among Newly-diagnosed Drugnaïve Persons Visiting a Voluntary Testing and Counselling Centre in Northeastern South Africa.
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Date
2011-08
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Abstract
Data on antiretroviral drug resistance among drug-naïve persons are important in developing sentinel
surveillance policies. This study was conducted to determine the prevalence of antiretroviral drug resistance
mutations among drug-naïve HIV-infected individuals attending a voluntary testing and counselling
centre at the Mankweng Hospital in northeastern South Africa. In total, 79 drug-naïve HIV-positive individuals
were sequentially recruited during February 2008–December 2008. Drug resistance mutations were
determined using the calibrated population resistance tool available on the Stanford HIV drug resistance
database. Viral DNA was obtained from 57 (72%) of the 79 individuals. Reliable nucleotide sequences were
obtained for 54 reverse transcriptase (RT) and 54 protease (PR) gene regions from 54 individuals. Overall,
five sequences (9.3%) harboured drug resistance mutations (95% confidence interval -1.53 to 16.99). Four
(7.4%) of these were nucleoside RT inhibitor mutations (D67G, D67E, T69D, and T215Y), and one (1.9%)
was a PR inhibitor mutation (M46I). No major non-nucleoside RT resistance mutation was detected. Several
minor resistance mutations and polymorphisms common in subtype C viruses were observed in the
PR and RT genes. Phylogenetic analysis of the partial pol sequences showed that 52 (96%) of the 54 isolates
were HIV-1 subtype C. One isolate (08MB08ZA) was HIV-1 subtype B while another (08MB26ZA) was related
to HIV-1 subtype J. HIV-1 subtype recombination analysis with REGA assigned the pol sequence to HIV
subtype J (11_cpx) with a bootstrap value of 75%. The prevalence of drug resistance mutations observed in
the population studied was relatively higher than previously reported from other parts of South Africa. In
addition, this is apparently the first report of an HIV-1 subtype J-like virus from northeastern South Africa.
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Keywords
Antiretrovirals, Drug resistance, Drug-naïve persons, HIV-1, South Africa
Citation
Nwobegahay Julius M, Bessong Pascal O, Masebe Tracy M, Mavhandu Lufuno G, Iweriebor Benson C, Selabe Gloria. Prevalence of Antiretroviral Drug Resistance Mutations and HIV-1 Subtypes among Newly-diagnosed Drugnaïve Persons Visiting a Voluntary Testing and Counselling Centre in Northeastern South Africa. Journal of Health, Population and Nutrition. 2011 Aug; 29(4): 303-309.