佛得角新诊断的HIV-1感染患者的基因多样性和抗逆转录病毒耐药性
Genetic Diversity and Antiretroviral Resistance in HIV-1-Infected Patients Newly Diagnosed in Cabo Verde.
作者信息
Leal Silvânia Da Veiga, Pimentel Victor, Gonçalves Paloma, Monteiro de Pina Araújo Isabel Inês, Parreira Ricardo, Taveira Nuno, Pingarilho Marta, Abecasis Ana B
机构信息
Instituto Nacional de Saúde Pública de Cabo Verde, Largo do Desastre da Assistência, Chã de Areia, Praia CP 7943-010, Cape Verde.
Global Health and Tropical Medicine, GHTM, Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Instituto de Higiene e Medicina Tropical, IHMT, Universidade NOVA de Lisboa, Rua da Junqueira 100, 1349-008 Lisboa, Portugal.
出版信息
Viruses. 2024 Dec 20;16(12):1953. doi: 10.3390/v16121953.
The high genetic variability of HIV-1 and the emergence of transmitted drug resistance (TDR) can impact treatment efficacy. In this study, we investigated the prevalent HIV-1 genotypes and drug-resistance-associated mutations in drug-naïve HIV-1 individuals in Cabo Verde. The study, conducted between 2018 and 2019, included drug-naïve HIV-1 individuals from the São Vicente, Boa Vista, Fogo, and Santiago islands. The HIV-1 gene was sequenced using Sanger sequencing. TDR was identified using the Stanford Calibrated Population Resistance tool, and resistance levels to different drugs were interpreted with the Stanford HIV database. The genetic diversity of HIV-1 was determined through phylogenetic analysis, and epidemiological and behavioural data were collected via questionnaires. Of the 73 participants, the majority were male (52.1%). The CRF02_AG recombinant form predominated (41.1%), followed by subtype G (37.0%). The overall prevalence of TDR was 9.6%. Nucleoside Reverse Transcriptase Inhibitor (NRTI) mutations occurred in 2.7% of individuals, while Non-Nucleoside Reverse Transcriptase Inhibitor (NNRTI) mutations occurred in 9.6%. The most prevalent mutations were K103N (5.5%) and M184V (2.7%). No protease- or integrase-associated mutations were found. The high levels of resistance to NNRTIs found demonstrate the need for surveillance of resistance mutations to ensure the efficacy and durability of the current therapeutic regimen, which includes Dolutegravir.
HIV-1的高遗传变异性以及传播性耐药(TDR)的出现会影响治疗效果。在本研究中,我们调查了佛得角未接受过抗逆转录病毒治疗的HIV-1感染者中流行的HIV-1基因型和耐药相关突变。该研究于2018年至2019年开展,纳入了来自圣维森特岛、博阿维斯塔岛、福戈岛和圣地亚哥岛的未接受过抗逆转录病毒治疗的HIV-1感染者。使用桑格测序法对HIV-1基因进行测序。使用斯坦福校准人群耐药工具鉴定TDR,并通过斯坦福HIV数据库解读对不同药物的耐药水平。通过系统发育分析确定HIV-1的遗传多样性,并通过问卷调查收集流行病学和行为学数据。在73名参与者中,大多数为男性(52.1%)。CRF02_AG重组型占主导(41.1%),其次是G亚型(37.0%)。TDR的总体流行率为9.6%。2.7%的个体出现核苷类逆转录酶抑制剂(NRTI)突变,而9.6%的个体出现非核苷类逆转录酶抑制剂(NNRTI)突变。最常见的突变是K103N(5.5%)和M184V(2.7%)。未发现蛋白酶或整合酶相关突变。所发现的对NNRTIs的高耐药水平表明需要对耐药突变进行监测,以确保包括多替拉韦在内的当前治疗方案的疗效和持久性。