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Prevalence of minor mutations and natural polymorphisms at the protease gene among treatment-naïve human immunodeficiency virus-1 infected individuals in Jos, Nigeria
Joseph A Anejo Okopi1, Patricia A Agaba2, Lohya Nimzing3, Placid O Ugoagwu1, Kenneth Were4, Harris Onywera4, Preston Owiti4, Newton Otecko4, Samson E Isa5, Joseph A. E. Okwori6, Solomon A Sagay7, Stephen Oguche8, John A Idoko9, Oche O Agbaji5, David E Jatau10, Steve O Olonitola10
1 AIDS Prevention Initiative in Nigeria Center, Jos University Teaching Hospital, Laboratory department, Plateau State, Nigeria
2 AIDS Prevention Initiative in Nigeria Center, Jos University Teaching Hospital, Laboratory department, Plateau State, Nigeria; Department of Family Medicine, Kenya Medical Research Institute, Kisian Kisumu, Kenya
3 AIDS Prevention Initiative in Nigeria Center, Jos University Teaching Hospital, Laboratory department, Plateau State, Nigeria; Department of Medical Microbiology, Kenya Medical Research Institute, Kisian Kisumu, Kenya
4 HIV-Research Laboratory, Kenya Medical Research Institute, Kisian Kisumu, Kenya
5 AIDS Prevention Initiative in Nigeria Center, Jos University Teaching Hospital, Laboratory department, Plateau State, Nigeria; Department of Medicine, University of Jos, Nigeria
6 Department of Microbiology, National Veterinary Research Institute, Vom
7 AIDS Prevention Initiative in Nigeria Center, Jos University Teaching Hospital, Laboratory department, Plateau State, Nigeria; Department of Obstetrics & Gynaecology, University of Jos, Nigeria
8 AIDS Prevention Initiative in Nigeria Center, Jos University Teaching Hospital, Laboratory department, Plateau State, Nigeria; Department of Pediatrics University of Jos, Nigeria
9 AIDS Prevention Initiative in Nigeria Center, Jos University Teaching Hospital, Laboratory department; Department of Medicine, University of Jos; Director General, National Agency for Control of AIDS, Abuja, Nigeria
10 Department of Microbiology, Ahmadu Bello University Zaria, Nigeria
Correspondence Address:
Joseph A Anejo Okopi
AIDS Prevention Initiative in Nigeria, Jos University Teaching Hospital, Plateau State, Nigeria
 Source of Support: This work was funded in part by the US Department of Health and Human Services, Health Resources and Services Administration (U51HA02522). The contents are solely the responsibility of the authors and do not represent the official views of the funding institutions, Conflict of Interest: None declared, Conflict of Interest: None  | Check |
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Background: Minor mutations to protease inhibitors often occur as polymorphisms in the protease gene in non-B human immunodeficiency virus (HIV)-1 subtype among antiretroviral (ARV) treatment-naïve patients. Aims: This study sought to determine the prevalence of minor mutations occurring in the protease gene among ARV naïve HIV-1 infected patients in Jos, Nigeria. Settings and Design: We retrospectively analyzed specimen of 105 patients recruited between October 2010 and April 2011 at the HIV clinic, Jos University Teaching Hospital, Nigeria. Materials and Methods : Genotypic testing was done using an in-house genotyping system at the Kenya Medical Research Institute HIV-Research Laboratory in Kisumu, Kenya; HIV-1 viral resistance mutations assessed using Stanford HIV drug resistance database and classified using International acquired immunodeficiency syndrome (AIDS) Society (IAS)-USA list of mutations. In additional, viral subtypes were determined using REGA subtyping tool v.2.0 and CD4 levels by flow cytometry. Statistical analysis: Prevalence of mutations was computed and participants' baseline clinical and biological properties summarized by percentages for categorical variables and mean/median for quantitative variables. Results: Of the 105 samples, 100 were successfully amplified. HIV-1 subtypes identified were circulating recombinant form (CRF) - CRF02_AG (48.0%), G (41.0%), CRF06_cpx (6.0%) and A1 (5.0%). The most prevalent minor mutations among the patients occurred at positions L89M (96%), M36I (93%), K20I (77%), V82I (39%), E35Q (29%), L63P (25%) and polymorphisms at I13V (99%), R41K (86%), H69K (86%), K14R (67%). One sample presented with a major PI resistance mutation (Q58E). Conclusions: We found high rates of minor mutations and polymorphisms in circulation, possibly reflecting the drug naivety of participants. In addition, there was an evidence of transmitted drug resistance, hence targeted genetic resistance testing should be considered in national treatment guidelines. |
