Sagoe Kwamena William Coleman, Dwidar Magdar, Lartey Margaret, Boamah Isaac, Agyei Afrakoma Adjoa, Hayford Anna Aba, Mingle Julius Abraham Addo, Arens Max Q
Clinical Virology Laboratory (Department of Microbiology), University of Ghana Medical School, Accra, Ghana.
J Clin Virol. 2007 Oct;40(2):163-7. doi: 10.1016/j.jcv.2007.07.016. Epub 2007 Sep 10.
Little is known about the HIV-1 drug resistance mutations in Ghana.
To determine the background protease (PR) and reverse transcriptase (RT) mutations of HIV-1 from treatment naïve patients in Ghana.
Twenty-five plasma samples randomly selected were analyzed for drug resistance mutations. The molecular phylogeny and recombinant patterns of the polymerase gene of HIV-1 were also analysed.
No major drug-resistance mutations were seen in protease or reverse transcriptase genes. The L10I, L10V, V11I and E35G minor mutations were seen in four patients, while the V179E was observed in a patient with subtype G. An insertion of lysine was found at codon 36 of the protease gene of one patient. The predominant subtype was the CRF02_AG strain (n=22), but 3 (13.6%) of these were recombinants with HIV-1 subtype K and/or A1. Two patients harboured unclassified/complex strains with D/CRF01_AE and G/CRFAG_02 subtypes for the PR and RT, respectively, using the Stanford Database. Viral loads (VL) ranged from 2290 to >1,500,000c/ml (mean=339,065c/ml).
Treatment naïve patients in Ghana before scale-up may have minor but not major PR mutations and high viral loads. The clinical effects of minor mutations/polymorphisms in the PR and RT genes and recombinants need to be investigated.
关于加纳的HIV-1耐药性突变情况知之甚少。
确定加纳未接受过治疗的患者中HIV-1的蛋白酶（PR）和逆转录酶（RT）背景突变。
对随机选取的25份血浆样本进行耐药性突变分析。同时分析HIV-1聚合酶基因的分子系统发育和重组模式。
蛋白酶或逆转录酶基因中未发现主要耐药性突变。4名患者出现了L10I、L10V、V11I和E35G等次要突变，1名G亚型患者出现了V179E突变。在1名患者的蛋白酶基因第36密码子处发现赖氨酸插入。主要亚型为CRF02_AG毒株（n = 22），但其中3株（13.6%）为与HIV-1 K亚型和/或A1亚型的重组体。使用斯坦福数据库，2名患者分别携带PR和RT的未分类/复杂毒株，PR为D/CRF01_AE亚型，RT为G/CRFAG_02亚型。病毒载量（VL）范围为2290至>1,500,000拷贝/毫升（平均 = 339,065拷贝/毫升）。
在扩大治疗规模之前，加纳未接受过治疗的患者可能存在次要而非主要的PR突变且病毒载量较高。PR和RT基因中的次要突变/多态性以及重组体的临床影响需要进一步研究。
