Profile of HIV Type 1 Infection and Genotypic Resistance Mutations to Antiretroviral Drugs in Treatment-Naive HIV Type 1-Infected Individuals in Hai Phong, Viet Nam

Abstract

We evaluated the prevalence and profile of antiretroviral treatment (ART)-associated resistance mutations among HIV-1 strains in northern Vietnam by genotypically analyzing strains isolated from ART-naive individuals in Hai Phong, a city in which HIV-1 is highly prevalent. Plasma samples were collected from injecting drug users (IDU, n = 760), female sex workers (FSW, n = 91), seafarers (n = 94), pregnant women (n = 200), and blood donors (n = 210), and screened for HIV-1 antibodies. Plasma viral RNA was extracted from HIV-1-positive samples, amplified by reverse transcriptase (RT)-PCR of protease and RT genes, and analyzed for genotypes and ART-associated resistance mutations. HIV-1 prevalence among IDU, FSW, seafarers, pregnant women, and blood donors was 35.9%, 23.1%, 0%, 0.5%, and 2.9%, respectively. Phylogenetic analyses revealed that the most prevalent HIV-1 subtype was CRF01_AE (98.3%), similar to strains prevalent in southern China. Four (1.4%) subtype B strains and one (0.3%) unique recombinant between subtypes B and C were also identified. We found protease inhibitor-associated major resistance mutations in one of the 294 cases analyzed (0.3%; mutation M46I). We found RT inhibitor-associated major resistance mutations in 7/273 cases (2.6%; one occurrence each of L74I, M184I, and K219E; three cases of K103N; and two cases of G190E). One CRF01_AE strain harboring a protease codon 35 insertion was first identified in Vietnam. Thus, monitoring of drug-resistant HIV-1 and establishment of a database are required for the proper selection of ART in Vietnam.

Hiv-1 Drug Resistance in Antiretroviral-Naive Individuals with HIV-1-Associated Tuberculous Meningitis Initiating Antiretroviral Therapy in Vietnam

“…Other non-synonymous polymorphisms at positions not associated with the 2009 WHO SDRMs are listed in Figure 1; similar polymorphism frequencies have been described in subtype CRF01_AE in other studies in Asia [18,32].…”

“…Of note, some natural polymorphisms were present at higher frequencies in this HCMC cohort compared to a study in northern Vietnam; both were overwhelmingly dominated by CRF01_AE subtype [18], that is, T69N (9.2% versus 0.4%), V106I (8.2% versus 1.5%) and V179I (17.4% versus 0%). The polymorphism L63C, which requires changes in all three nucleotides, was present in 45.4% of samples in this cohort.…”

“…ART was initially introduced in Vietnam in the mid-1990s through private donations with intermittent drug supply and through the black market with high prices, so treatment interruption was likely common. In addition, non-nucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs) were not available or too expensive during the early 2000s, hence dual therapy regimens with zidovudine and lamivudine or stavudine and didanosine were commonly used (Donn Colby [16][17][18][19][20][21]. Differences in reported prevalence may reflect differences in populations and time periods studied, in survey methods and drug resistance algorithms used, and in geographic and sample size factors, thereby making comparison and estimation problematic.…”

Genetic Analyses of HIV-1 Strains Transmitted from Mother to Child in Northern Vietnam

“…To amplify HIV-1 pol-RT, the primer pairs RT18/K104 and K101/K102 were used in the first and second round, respectively, when the PCR reaction with the previous primer pairs failed. [23][24][25] RT-PCR was performed with one cycle at 55°C for 30 min and one cycle at 94°C for 2 min, then 40 cycles at 94°C for 15 s, 55°C (for DRPRO5/DRPRO2L and DRRT1L/RTout primer pairs) or 50°C (for the other primer sets) for 30 s, and 68°C for 1 min, with a final extension of 68°C for 5 min. [23][24][25] Nested PCR for pol-PR was performed with one cycle at 95°C for 10 min, followed by 40 cycles at 95°C for 30 s, 55°C for 30 s, and 72°C for 1 min, with a final extension at 72°C for 10 min using Ampli Taq Gold.…”

HIV Drug Resistance at Patients on HAART and Transmitted HIV Drug Resistance (tHIVDR) in Treatment Naive Patients in Belarus

“…39 (66.1%) of 59 adult patients are classified as IDUs, who, according to general experience, do not always express high degree of adherence to therapy [3][4][5].…”