High level of HIV-1 drug resistance among patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau

Virology Journal

Alex Lund Laursen²  Christian Wejse⁴  Lars Østergaard²  Svend Ellermann-Eriksen⁵  David da Silva Té³  Candida Medina³  Bo Langhoff Hønge¹  Martin Tolstrup²  Sanne Jespersen² 

[1] Department of Clinical Immunology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, 8200, Denmark;Department of Infectious Diseases, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, 8200, Denmark;National HIV Programme, Ministry of Health, Bissau, Bissau, CP 1013, Guinea-Bissau;GloHAU, Center for Global Health, School of Public Health, Aarhus University, Bartholins Allé 2, Aarhus C, 8000, Denmark;Department of Clinical Microbiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, Aarhus N, 8200, Denmark

关键词: Guinea-Bissau;    Antiretroviral treatment;    Drug resistance;    Sub-Saharan Africa;    HIV-1/2 dual infection;    HIV-1;   

Others  :  1145086
DOI  :  10.1186/s12985-015-0273-9

 received in 2014-12-25, accepted in 2015-02-26,  发布年份 2015

【 摘 要 】

Background

With the widespread use of antiretroviral treatment (ART) in Africa, the risk of drug resistance has increased. The aim of this study was to evaluate levels of HIV-1 resistance among patients with HIV-1 and HIV-1/2 dual infections, treated with ART, at a large HIV clinic in Guinea-Bissau.

Findings

Patients were selected from the Bissau HIV cohort. All patients had HIV-1 or HIV-1/2 dual infection, a CD4 cell count performed before and 3–12 months after starting ART, and a corresponding available plasma sample. We measured viral load in patients with HIV-1 (n = 63) and HIV-1/2 dual (n = 16) infections a median of 184 days after starting ART (IQR: 126–235 days). In patients with virological failure (defined as viral load >1000 copies/ml) and with sufficient plasma available, we performed an HIV-1 genotypic resistance test. Thirty-six patients (46%) had virological failure. The CD4 cell count did not predict treatment failure. Of the 36 patients with virological failure, we performed a resistance test in 15 patients (42%), and nine patients (9/15; 60%) had resistance mutations. The most common mutation was K103N, which confers high-level resistance to non-nucleoside reverse transcriptase inhibitors (NNRTI). No major mutations against protease inhibitors (PI) were found.

Conclusions

Our results showed that patients with HIV-1 and HIV-1/2 dual infections in Guinea-Bissau had a high rate of virological failure and rapid development of NNRTI resistance. It remains to be determined whether a more robust, PI-based treatment regimen might benefit this population more than NNRTIs.

【 授权许可】

   
2015 Jespersen et al.; licensee BioMed Central.

【 图 表 】

Figure 1.

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