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Drug resistance mutations in protease gene of HIV-1 subtype C infected patient population. Virusdisease 2021; 32:480-491. [PMID: 34631975 DOI: 10.1007/s13337-021-00725-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 06/29/2021] [Indexed: 10/20/2022] Open
Abstract
Failure of antiretroviral therapy (ART) in HIV-1 infection is a critical issue for the physicians treating HIV patients. The major cause of drug failure is the development of resistance mutations in reverse transcriptase (RT) and/or protease (PR) genes. Mutations associated with drug resistance decrease drug effectiveness. This study was conducted to assess drug resistance profile of the entire PR gene in 90 HIV-1 patients consisting of 23 ART non-responsive, 32 ART responsive and 35 drug naive patients. It was observed that the majority of the sequences (94.4%) belonged to subtype C and (5.5%) to subtype A1. The ART non-responsive and responsive patients were treated with either first line of ART regimen (two NRTI and one NNRTI) or second line of ART regimen that included additional one protease inhibitor (PI). All the patients in each group except one responsive patient had various minor resistance mutations. Thus, drug failures in ART non-responsive patients may not always be due to drug resistance mutations instead other factors may also be responsible for drug failures such as non-compliance, suboptimal dose or drug interaction. The presence of minor drug resistance mutations in drug naive patients is suggestive of transmitted resistance mutations.
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El Moussi A, Thomson MM, Delgado E, Cuevas MT, Nasr M, Abid S, Ben Hadj Kacem MA, Benaissa Tiouiri H, Letaief A, Chakroun M, Ben Jemaa M, Hamdouni H, Tej Dellagi R, Kheireddine K, Boutiba I, Pérez-Álvarez L, Slim A. Genetic Diversity of HIV-1 in Tunisia. AIDS Res Hum Retroviruses 2017; 33:77-81. [PMID: 27473255 DOI: 10.1089/aid.2016.0164] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
In this study, the genetic diversity of HIV-1 in Tunisia was analyzed. For this, 193 samples were collected in different regions of Tunisia between 2012 and 2015. A protease and reverse transcriptase fragment were amplified and sequenced. Phylogenetic analyses were performed through maximum likelihood and recombination was analyzed by bootscanning. Six HIV-1 subtypes (B, A1, G, D, C, and F2), 5 circulating recombinant forms (CRF02_AG, CRF25_cpx, CRF43_02G, CRF06_cpx, and CRF19_cpx), and 11 unique recombinant forms were identified. Subtype B (46.4%) and CRF02_AG (39.4%) were the predominant genetic forms. A group of 44 CRF02_AG sequences formed a distinct Tunisian cluster, which also included four viruses from western Europe. Nine viruses were closely related to isolates collected in other African or in European countries. In conclusion, a high HIV-1 genetic diversity is observed in Tunisia and the local spread of CRF02_AG is first documented in this country.
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Affiliation(s)
- Awatef El Moussi
- Unit Virology, Microbiology Laboratory, Charles Nicolle University Hospital, Tunis, Tunisia
- Laboratory of Research “resistance to antibiotics,” Faculty of Medicine of Tunis, Tunis, Tunisia
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
| | - Michael M. Thomson
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Elena Delgado
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - María Teresa Cuevas
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Majda Nasr
- Unit Virology, Microbiology Laboratory, Charles Nicolle University Hospital, Tunis, Tunisia
| | - Salma Abid
- Unit Virology, Microbiology Laboratory, Charles Nicolle University Hospital, Tunis, Tunisia
- Laboratory of Research “resistance to antibiotics,” Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Mohamed Ali Ben Hadj Kacem
- Unit Virology, Microbiology Laboratory, Charles Nicolle University Hospital, Tunis, Tunisia
- Laboratory of Research “resistance to antibiotics,” Faculty of Medicine of Tunis, Tunis, Tunisia
| | | | - Amel Letaief
- Infectious Diseases Department, Farhat Hached University Hospital, Sousse, Tunisia
| | - Mohamed Chakroun
- Infectious Diseases Department, Fatouma Bourguiba University Hospital, Monastir, Tunisia
| | - Mounir Ben Jemaa
- Infectious Diseases Department, Hedi Chaker University Hospital of Sfax, Sfax, Tunisia
| | - Hayet Hamdouni
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
- Primary Health Care Directory (DSSB), Ministry of Health, Tunis, Tunisia
| | - Rafla Tej Dellagi
- Primary Health Care Directory (DSSB), Ministry of Health, Tunis, Tunisia
| | - Khaled Kheireddine
- The Global Fund to Fight AIDS, Tuberculosis and Malaria, Geneva, Switzerland
- National Office of Family and Population, Tunis, Tunisia
| | - Ilhem Boutiba
- Unit Virology, Microbiology Laboratory, Charles Nicolle University Hospital, Tunis, Tunisia
- Laboratory of Research “resistance to antibiotics,” Faculty of Medicine of Tunis, Tunis, Tunisia
| | - Lucía Pérez-Álvarez
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Amine Slim
- Unit Virology, Microbiology Laboratory, Charles Nicolle University Hospital, Tunis, Tunisia
- Laboratory of Research “resistance to antibiotics,” Faculty of Medicine of Tunis, Tunis, Tunisia
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Kouyoumjian SP, Mumtaz GR, Hilmi N, Zidouh A, El Rhilani H, Alami K, Bennani A, Gouws E, Ghys PD, Abu-Raddad LJ. The epidemiology of HIV infection in Morocco: systematic review and data synthesis. Int J STD AIDS 2014; 24:507-16. [PMID: 23970764 PMCID: PMC3764773 DOI: 10.1177/0956462413477971] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Morocco has made significant strides in building its HIV research capacity. Based on a wealth of empirical data, the objective of this study was to conduct a comprehensive and systematic literature review and analytical synthesis of HIV epidemiological evidence in this country. Data were retrieved using three major sources of literature and data. HIV transmission dynamics were found to be focused in high-risk populations, with female sex workers (FSWs) and clients contributing the largest share of new HIV infections. There is a pattern of emerging epidemics among some high-risk populations, and some epidemics, particularly among FSWs, appear to be established and stable. The scale of the local HIV epidemics and populations affected show highly heterogeneous geographical distribution. To optimize the national HIV response, surveillance and prevention efforts need to be expanded among high-risk populations and in geographic settings where low intensity and possibly concentrated HIV epidemics are emerging or are already endemic.
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Affiliation(s)
- S P Kouyoumjian
- Infectious Disease Epidemiology Group, Weill Cornell Medical College - Qatar, Cornell University, Qatar Foundation - Education City, Doha, Qatar
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Saison J, Tardy JC, Scholtes C, Icard V, Trabaud MA, Perpoint T, Chidiac C, Ecochard R, André P, Ferry T. Low-level viremia is associated with non-B subtypes in patients infected with HIV with virological success following HAART introduction. J Med Virol 2013; 85:953-8. [PMID: 23588720 DOI: 10.1002/jmv.23553] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/14/2013] [Indexed: 12/14/2022]
Abstract
This prospective study aimed to determine factors associated with detection of very low-level viremia in patients infected with HIV-1 with virological success following HAART introduction. Fifty-seven patients, mostly (n = 51, 89%) treated with a protease inhibitor-based regimen, were included and followed for 2 years. Viral loads were monitored by Abbott m2000 RealTime HIV-1. Patients were classified as (i) HIV-RNA-negative if viral loads remained strictly undetectable (0 copies/ml), or (ii) HIV-RNA-positive if at least one HIV-1 RNA could be detected in 1-49 copies/ml during follow-up. At month 24, 44 patients (77%) were in the HIV-RNA-positive group, whereas 13 (23%) remained without very low-level viremia. Univariate analysis, Kaplan-Meier curves and the Cox proportional hazard model revealed that B subtype was the only predictor of belonging to the HIV-RNA-negative group (HR 3.98; 95% CI 1.08-14.7). This association needs to be confirmed. Further study of the reservoir and the mechanisms of viral latency according to HIV-subtype will also be necessary to develop new therapeutic strategies and eradicate HIV infection.
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Affiliation(s)
- Julien Saison
- Virology Laboratory, Croix-Rousse Hospital, HCL, Lyon, France
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Azam M, Malik A, Rizvi M, Singh S, Gupta P, Rai A. Emergence of drug resistance-associated mutations in HIV-1 subtype C protease gene in north India. Virus Genes 2013; 47:422-8. [PMID: 23888308 DOI: 10.1007/s11262-013-0961-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2013] [Accepted: 07/12/2013] [Indexed: 10/26/2022]
Abstract
A major cause of anti-retroviral therapy (ART) failure is the drug resistance-associated mutations in polymerase gene of HIV-1. Paucity of data regarding potential drug resistance to protease inhibitors (PIs) prompted us to carry out this study. Drug resistance (DR) genotyping of the entire protease gene was performed in 104 HIV-1 ART-naive and first-line ART-experienced patients. The DR pattern was analyzed using the Stanford HIV-DR database, International AIDS Society-USA mutation list and REGA algorithm version 8.0. Subtyping was done using Mega 4 and REGA HIV-1 subtyping tool-v2.01. Majority of our sequences 98 (96%) were subtype C and remaining four (3.92%) were subtype A1. In three (2.9%) DE patients, major DR-associated mutation at D30 N and M46I positions were detected. Approximately 70% polymorphisms as minor mutations were observed in protease gene, of which 14 distinct amino acids changes were linked to partial DR such as G16E, K20R, M36I, D60E, I62V, L63P, I64M, H69K, T74A/S, V77I, V82I, I85V, L89M, and I93L. The two major and several minor mutations detected in this study confer low/intermediate levels of resistance to most PIs independently or together. Our results conclude that resistance testing in HIV-1-infected patients should be performed before the initiation of PI therapy for better therapeutic outcome in this region. This information not only will shed light on the extent of current DR in HIV strains but also will aid in patient treatment and drug designing.
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Affiliation(s)
- Mohd Azam
- Department of Microbiology, Faculty of Medicine, J.N. Medical College, Aligarh Muslim University, Aligarh, 202002, India
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