Low rate of genotypic HIV-1 drug-resistant strains in the Senegalese government initiative of access to antiretroviral therapy

Vergne, Laurence; Kane, Coumba Touré; Laurent, Christian; Diakhaté, Ndella; Gueye, Ndèye Fatou Ngom; Gueye, P.M.; Sow, Papa Salif; Faye, Mame Awa; Liégeois, Florian; Ndir, Adama; Lanièce, Isabelle; Peeters, Martine; Ndoye, Ibrahima; Mboup, Souleymane; Delaporte, Eric

doi:10.1097/00002030-200317003-00005

Cited by 41 publications

(22 citation statements)

References 17 publications

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“…The T215Y/F mutation confers resistance to ZDV in nearly all HIV-1 isolates, whereas Y118C is a mutation related to native versus nucleoside analog discrimination but confers only low-level resistance (10,11,30). Limited studies on ART drug resistance in Africa, especially for non-B subtypes in Europe, have shown a strong correlation between the presence of major mutations and phenotypic resistance, similar to the case for mutations seen in subtype B infections with similar treatment regimens (31,33).…”

Section: Discussionmentioning

confidence: 99%

“…With the rapid introduction of ART and with limited health care infrastructure for care and monitoring, this country may face similar emergence rates of ARV resistance to those described for other developing countries (29,30). With a higher prevalence of ARV resistance in the drug-naïve population (18,32), resistance may emerge at an even higher rate.…”

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confidence: 95%

“…Since the successful trials in the late 1990s, combination ART has benefited and continues to aid many human immunodeficiency virus type 1 (HIV-1)-infected patients in developed countries, and it is becoming increasingly available in resourceconstrained countries (17,20,24,29,30).…”

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confidence: 99%

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Molecular Characterization of Human Immunodeficiency Virus Type 1 (HIV-1) and HIV-2 in Yaoundé, Cameroon: Evidence of Major Drug Resistance Mutations in Newly Diagnosed Patients Infected with Subtypes Other than Subtype B

et al. 2008

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Prior to current studies on the emergence of drug resistance with the introduction of antiretroviral therapy (ART) in Cameroon, we performed genotypic analysis on samples from drug-naïve, human immunodeficiency virus (HIV)-infected individuals in this country. Of the 79 HIV type 1 (HIV-1) pol sequences analyzed from Cameroonian samples, 3 (3.8%) were identified as HIV-1 group O, 1 (1.2%) was identified as an HIV-2 intergroup B/A recombinant, and the remaining 75 (95.0%) were identified as HIV-1 group M. Group M isolates were further classified as subtypes A1 (n ‫؍‬ 4), D (n ‫؍‬ 4), F2 (n ‫؍‬ 6), G (n ‫؍‬ 12), H (n ‫؍‬ 2), and K (n ‫؍‬ 1) and as circulating recombinant forms CRF02_AG (n ‫؍‬ 41), CRF11_cpx (n ‫؍‬ 1), and CRF13_cpx (n ‫؍‬ 2). Two pol sequences were identified as unique recombinant forms of CRF02_AG/F2 (n ‫؍‬ 2). M46L (n ‫؍‬ 2), a major resistance mutation associated with resistance to protease inhibitors, was observed in 2/75 (2.6%) group M samples.

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Section: Discussionmentioning

confidence: 99%

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confidence: 95%

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Molecular Characterization of Human Immunodeficiency Virus Type 1 (HIV-1) and HIV-2 in Yaoundé, Cameroon: Evidence of Major Drug Resistance Mutations in Newly Diagnosed Patients Infected with Subtypes Other than Subtype B

et al. 2008

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“…After first-line ART failure, a boosted protease inhibitor with two NRTIs has been recommended for second-line ART (7). In a prospective observational cohort study, it was shown that the implementation of highly active ART (HAART), in combination with clinical, biological, and logistical monitoring, reduced the emergence of resistant strains in Africa (8). The WHO guidelines also suggest that the first-line ART regimen should be switched after immunological or clinical failure when plasma HIV-1 RNA load tests are not available (7).…”

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confidence: 99%

HIV-1 Genetic Diversity and Drug Resistance among Senegalese Patients in the Public Health System

et al. 2013

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In this study, we investigated the prevalence of human immunodeficiency virus type 1 (HIV-1) drug resistance mutations and genetic variability among Senegalese patients undergoing highly active antiretroviral therapy (ART) in the public health system. We conducted a cross-sectional study of 72 patients with suspected therapeutic failure. HIV-1 genotyping was performed with Viroseq HIV-1 Genotyping System v2.0 or the procedure developed by the ANRS AC11 resistance study group, and a phylogenetic analysis was performed. The median follow-up visit was at 40 (range, 12 to 123) months, and the median viral load was 4.67 (range, 3.13 to 6.94) log 10 copies/ml. The first-line therapeutic regimen was nucleoside reverse transcriptase inhibitors (NRTIs) plus efavirenz (EFV) or NRTIs plus nevirapine (NVP) (54/72 patients; 75%), and the second-line therapy was NRTIs plus a protease inhibitor (PI/r) (18/72; 25%). Fifty-five patients (55/72; 76.39%) had at least one drug resistance mutation. The drug resistance rates were 72.22 and 88.89% for the first-line and second-line ARTs, respectively. In NRTI mutations, thymidine analog mutations (TAMs) were found in 50.79% and the M184V mutation was found in 34.92% of the samples. For non-NRTI resistance, we noted a predominance of the K103N mutation (46.27%). For PI/r, several cases of mutations were found with a predominance of M46I and L76V/F at 24% each. The phylogenetic analysis revealed CRF02_AG as the predominant circulating recombinant form (43/72; 59.72%). We found a high prevalence of resistance mutations and a high rate of TAMs among Senegalese patients in the public health system. These findings emphasize the need to improve virological monitoring in resource-limited settings.

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“…While highly active antiretroviral therapy (HAART) suppresses replication of HIV-1, its effectiveness is often limited by the emergence of antiretroviral drug-resistant mutants (28). Replication of drug-resistant HIV-1 during HAART is a major cause of treatment failure (32). Consequently, novel approaches to delay treatment failure are urgently required.…”

mentioning

confidence: 99%

Beneficial Effects of a Combination of Korean Red Ginseng and Highly Active Antiretroviral Therapy in Human Immunodeficiency Virus Type 1-Infected Patients

Sung

Jung²,

Cho³

2009

Clin Vaccine Immunol

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To determine whether Korean red ginseng (KRG) has beneficial effects on human immunodeficiency virus type 1 (HIV-1)-infected patients administered highly active antiretroviral therapy (HAART), we analyzed the CD4 T-cell count, viral load, and resistance mutations to HAART in 46 individuals. Thirteen patients harbored resistance mutations at baseline. The study population was divided into two groups: specifically, a group treated with a combination of HAART plus KRG (23 patients) and a group treated with HAART alone (23 patients). The annual increase in CD4 T-cell count in the combination group was significantly higher than that in the group treated with HAART alone (P < 0.05). Overall, 21 patients harbored resistance mutations after 3 years of therapy. Following exclusion of 13 patients displaying baseline resistance mutations, 7.1% of patients (1/14) in the combination group and 42.1% (8/19) in the HAART group were identified with resistance mutations. One patient with baseline resistance mutations in the combination group did not display resistance mutations 3 years after HAART therapy. High-level resistance mutations were significantly lower in the combination group than in the group treated with HAART alone. Five patients showed no improvement in viral copy number (26.3% [5/19]) in the combination group and 9 (45.0% [9/20]) showed no improvement in the HAART-only group. Our data support the clinical utility of KRG intake during HAART therapy.

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Low rate of genotypic HIV-1 drug-resistant strains in the Senegalese government initiative of access to antiretroviral therapy

Cited by 41 publications

References 17 publications

Molecular Characterization of Human Immunodeficiency Virus Type 1 (HIV-1) and HIV-2 in Yaoundé, Cameroon: Evidence of Major Drug Resistance Mutations in Newly Diagnosed Patients Infected with Subtypes Other than Subtype B

Molecular Characterization of Human Immunodeficiency Virus Type 1 (HIV-1) and HIV-2 in Yaoundé, Cameroon: Evidence of Major Drug Resistance Mutations in Newly Diagnosed Patients Infected with Subtypes Other than Subtype B

HIV-1 Genetic Diversity and Drug Resistance among Senegalese Patients in the Public Health System

Beneficial Effects of a Combination of Korean Red Ginseng and Highly Active Antiretroviral Therapy in Human Immunodeficiency Virus Type 1-Infected Patients

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