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加纳 HIV-1 的分子流行病学：亚型分布、耐药性和核心受体使用情况。

Molecular Epidemiology of HIV-1 in Ghana: Subtype Distribution, Drug Resistance and Coreceptor Usage.

机构信息

Faculty of Health Sciences, Simon Fraser University, Burnaby, BC V5A 1S6, Canada.

British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC V6Z 1Y6, Canada.

出版信息

Viruses. 2022 Dec 31;15(1):128. doi: 10.3390/v15010128.

DOI:10.3390/v15010128
PMID:36680168
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9865111/
Abstract

The greatest HIV-1 genetic diversity is found in West/Central Africa due to the pandemic’s origins in this region, but this diversity remains understudied. We characterized HIV-1 subtype diversity (from both sub-genomic and full-genome viral sequences), drug resistance and coreceptor usage in 103 predominantly (90%) antiretroviral-naive individuals living with HIV-1 in Ghana. Full-genome HIV-1 subtyping confirmed the circulating recombinant form CRF02_AG as the dominant (53.9%) subtype in the region, with the complex recombinant 06_cpx (4%) present as well. Unique recombinants, most of which were mosaics containing CRF02_AG and/or 06_cpx, made up 37% of sequences, while “pure” subtypes were rare (<6%). Pretreatment resistance to at least one drug class was observed in 17% of the cohort, with NNRTI resistance being the most common (12%) and INSTI resistance being relatively rare (2%). CXCR4-using HIV-1 sequences were identified in 23% of participants. Overall, our findings advance our understanding of HIV-1 molecular epidemiology in Ghana. Extensive HIV-1 genetic diversity in the region appears to be fueling the ongoing creation of novel recombinants, the majority CRF02_AG-containing, in the region. The relatively high prevalence of pretreatment NNRTI resistance but low prevalence of INSTI resistance supports the use of INSTI-based first-line regimens in Ghana.

摘要

由于该地区是艾滋病大流行的起源地，因此在西非和中非发现了最大的 HIV-1 遗传多样性，但对这种多样性的研究仍然不足。我们对加纳 103 名主要（90%）未经抗逆转录病毒治疗的 HIV-1 感染者的 HIV-1 亚型多样性（来自亚基因组和全长病毒序列）、耐药性和核心受体使用情况进行了描述。全长 HIV-1 亚型分型证实，流行重组形式 CRF02_AG 是该地区的主要（53.9%）亚型，复杂重组 06_cpx（4%）也存在。独特的重组体，其中大多数是包含 CRF02_AG 和/或 06_cpx 的嵌合体，占序列的 37%，而“纯”亚型很少（<6%）。在该队列中，有 17%的患者至少对一种药物类别存在预处理耐药性，其中最常见的是 NNRTI 耐药（12%），而 INSTI 耐药相对较少（2%）。在 23%的参与者中发现了使用 CXCR4 的 HIV-1 序列。总的来说，我们的研究结果加深了对加纳 HIV-1 分子流行病学的理解。该地区 HIV-1 遗传多样性广泛，似乎正在推动该地区新型重组体的不断产生，其中大多数含有 CRF02_AG。预处理 NNRTI 耐药率相对较高，但 INSTI 耐药率较低，支持加纳使用基于 INSTI 的一线治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/3611da9d38c7/viruses-15-00128-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/ca9c42ff63b4/viruses-15-00128-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/af65da926ef8/viruses-15-00128-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/4b4a20232f8d/viruses-15-00128-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/ce8ff5058393/viruses-15-00128-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/3807bac2d1a6/viruses-15-00128-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/e4b0d8be3a74/viruses-15-00128-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/ec18a2fa8f05/viruses-15-00128-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/22408335e1ed/viruses-15-00128-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/c49fed1f7264/viruses-15-00128-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/ab28e5e1913e/viruses-15-00128-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/3611da9d38c7/viruses-15-00128-g011.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/ca9c42ff63b4/viruses-15-00128-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/af65da926ef8/viruses-15-00128-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/4b4a20232f8d/viruses-15-00128-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/ce8ff5058393/viruses-15-00128-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/3807bac2d1a6/viruses-15-00128-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/e4b0d8be3a74/viruses-15-00128-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/ec18a2fa8f05/viruses-15-00128-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/22408335e1ed/viruses-15-00128-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/c49fed1f7264/viruses-15-00128-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/ab28e5e1913e/viruses-15-00128-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3a52/9865111/3611da9d38c7/viruses-15-00128-g011.jpg

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[3]
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[4]
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[5]
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[6]
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本文引用的文献

[1]
High-level resistance to non-nucleos(t)ide reverse transcriptase inhibitor based first-line antiretroviral therapy in Ghana; A 2017 study.

Front Microbiol. 2022-8-25

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Using a mixed-methods approach to adapt an HIV stigma reduction to address intersectional stigma faced by men who have sex with men in Ghana.

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