reverse transcriptase drug resistance mutations in hiv-1 subtype c infected patients on art in karonga district, malawi在hiv - 1逆转录酶耐药突变c亚型感染患者在karonga艺术区,马拉维.pdfVIP

Bansode et al. AIDS Research and Therapy 2011, 8:38 /content/8/1/38 SHORT REPORT Open Access Reverse transcriptase drug resistance mutations in HIV-1 subtype C infected patients on ART in Karonga District, Malawi 1 2 3,4 3,4 3,4 4 Vijay B Bansode , Simon AA Travers , Amelia C Crampin , Bagrey Ngwira , Neil French , Judith R Glynn and Grace P McCormack1* Abstract Background: Drug resistance testing before initiation of, or during, antiretroviral therapy (ART) is not routinely performed in resource-limited settings. High levels of viral resistance circulating within the population will have impact on treatment programs by increasing the chances of transmission of resistant strains and treatment failure. Here, we investigate Drug Resistance Mutations (DRMs) from blood samples obtained at regular intervals from patients on ART (Baseline-22 months) in Karonga District, Malawi. One hundred and forty nine reverse transcriptase (RT) consensus sequences were obtained via nested PCR and automated sequencing from blood samples collected at three-month intervals from 75 HIV-1 subtype C infected individuals in the ART programme. Results: Fifteen individuals showed DRMs, and in ten individuals DRMs were seen from baseline samples (reported to be ART naïve). Three individuals in whom no DRMs were observed at baseline showed the emergence of DRMs during ART exposure. Four individuals who did show DRMs at baseline showed additional DRMs at subsequent time points, while two individuals showed evidence of DRMs at baseline and either no DRMs, or different DRMs, at later timepoints. Three individuals had immune failure but none appeared to be failing clinically. Conclusion: Despite