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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
High level of primary drug resistance in Mali
HIV Medicine, Volume 11, No. 6, Year 2010
Notification
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Description
Background: As access to antiretroviral drugs increases in developing countries, it will become increasingly important to monitor the emergence of resistance and to define the molecular pathways involved to identify optimal therapeutic regimens. Methods: We performed genotypic resistance testing on plasma obtained from 101 HIV-infected treatment-naïve individuals from Mali. Genotyping was carried out using the Virco protocols and HXB2 was used as the reference strain. Results: CRF02_AG was the most common subtype, present in 71.3% of our patient population. Other subtypes included B, C, G, CRF06_CPX, CRF09_CPX, CRF01_AE, A2/CRF16_A2D, A1 and CRF13_CPX. A total of 9.9% [95% confidence interval (CI) 6.9-12.9%] of patients had at least one resistance mutation. The prevalences of mutations conferring resistance to nucleoside reverse transcriptase inhibitors (NRTIs), nonnucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs) were 5% (95% CI 0.7-9.2%), 6% (95% CI 1.3-10.6%) and 0%, respectively. The most frequent mutations were T215A/Y for NRTIs and K103N/T for NNRTIs. One patient harboured three NRTI resistance mutations and one NNRTI mutation. This is the first reported case of multi-drug-resistant viral transmission in Mali. Polymorphisms at protease codons 10I/V and 33F potentially associated with resistance were observed in 18.8% and 1% of patients, respectively. Several polymorphisms in the C-terminal domain of reverse transcriptase were observed: A371V (in 63.4% of patients), G335D (76.2%), E399D (10.9%) and G333E (1%). Conclusion: Primary resistance was seen in 9.9% of subjects, which is higher than previously reported in Mali. Taking into consideration other polymorphisms in protease such as L10I/V and 33F, primary resistance could reach 28.7% (95% CI 19.9-37.5%). Our study reflects the need to monitor the evolution of resistance on a regular basis and trends of transmitted resistance. © 2010 British HIV Association.
Authors & Co-Authors
Haidara, Alpha
Canada, Montreal
University of Montreal
Chamberland, Annie
Canada, Montreal
University of Montreal
Canada, Montreal
Centre Hospitalier de L'universite de Montreal
Sylla, Mohamed
Canada, Montreal
Centre Hospitalier de L'universite de Montreal
Aboubacrine, Souleymane Ag
Mali, Bamako
Hopital National du Point g
Cissé, Mamadou C.
Mali, Bamako
Cesac
Traoré, Hammar Alassane
Mali, Bamako
Hopital National du Point g
Maïga, Moussa Youssouffa
Mali, Bamako
Hopital Gabriel Toure
Tounkara, Anatole
Mali, Bamako
Hopital National du Point g
Nguyen, Vinh Kim
Canada, Montreal
University of Montreal
Tremblay, Cécile L.
Canada, Montreal
University of Montreal
Canada, Montreal
Centre Hospitalier de L'universite de Montreal
Statistics
Citations: 25
Authors: 10
Affiliations: 5
Identifiers
Doi:
10.1111/j.1468-1293.2009.00806.x
ISSN:
14642662
e-ISSN:
14681293
Research Areas
Cancer
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study
Study Locations
Mali