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Volume 66, Issue 11

Dynamic HIV-1 genetic recombination and genotypic drug resistance among treatment-experienced adults in northern Ghana Free

Abstract

There have been hardly any reports on the human immunodeficiency virus type 1 (HIV-1) drug-resistance profile from northern Ghana since antiretroviral therapy (ART) was introduced over a decade ago. This study investigated prevailing HIV-1 subtypes and examined the occurrence of drug resistance in ART-experienced patients in Tamale, the capital of the Northern Region of Ghana.

A cross-sectional study was carried out on HIV-infected adult patients receiving first-line ART. HIV viral load (VL) and CD4 T-cell counts were measured. The gene sequences were analysed for genotypic resistance by an in-house HIV-1 drug-resistance test; the prevailing HIV-1 subtypes were analysed in detail.

A total of 33 subjects were studied. Participants comprised 11 males (33.3 %) and 22 (66.7 %) females, with a median age of 34.5 years [interquartile range (IQR) 30.0–40.3]. The median duration on ART was 12 months (IQR 8.0–24). Of the 24 subjects successfully genotyped, 10 (41.7 %) viruses possessed at least one mutation conferring resistance to nucleoside or non-nucleoside reverse-transcriptase inhibitors (NRTIs/NNRTIs). Two-class drug resistance to NRTI and NNRTI was mostly detected (25 %, 6/24). The most frequent mutations were lamivudine-resistance M184V and efavirenz/nevirapine-resistance K103N. HIV-1 subtype CRF02_AG was predominant (79.2 %). Other HIV-1 subtypes detected were G (8.3 %), A3 (4.2 %) and importantly two (8.3 %) unique HIV-1 recombinant forms with CRF02_AG/A3 mosaic.

HIV-1 shows high genetic diversity and on-going viral genetic recombination in the study region. Nearly 42 % of the patients studied harboured a drug-resistant virus. The study underscores the need for continued surveillance of HIV-1 subtype diversity; and of drug-resistance patterns to guide selection of second-line regimens in northern Ghana.

  • Received:
  • Accepted:
  • Published Online:
Keyword(s): Antiretroviral therapy , genotypic resistance , molecular epidemiology and recombinant HIV-1
© 2017 The Authors
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2017-11-01
2024-04-19
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References

  1. Addo N, Yawson A, Addo AS, Dornoo BT, Seneadza HNA. A Review of National Programme Data on the HIV Epidemic in Ghana: 2005–2010. Posgraduate Med J Ghana 2014; 3:73–81
     [Google Scholar]
  2. Ghana AIDS Commission Summary of the 2016 HIV sentinel survey report. www.ghanaids.gov.gh/gac1/aids_info.php Accessed 27 September 2017
  3. van der Geest K. North-South Migration in Ghana: what role for the environment?. Int Migr 2011; 49:e69e94 [View Article]
     [Google Scholar]
  4. World Health Organization UNAIDS report on the global AIDS epidemic 2013. www.who.int/hiv/pub/me/unaids_global_report/en/ Accessed 15 September 2017
  5. National AIDS/STI Control Programme Ghana 90-90-90 campaign roadmap: locate, test, treat and retain (L2TR) Ghana campaign ending the AIDS epidemic by 2030. www.ccmghana.net/index.php/strategic-plans-reports?download=92:90-90-90-roadmap-to-treat-all Accessed 27 September 2017
  6. Ghana AIDS Commission 2014 status report. www.ghanaids.gov.gh/gac1/pubs/2014 STATUS REPORT.pdf Accessed 19 September 2017
  7. UNAIDS Global AIDS Update 2016. www.who.int/hiv/pub/arv/global-AIDS-update Accessed 27 September 2017
  8. Sidibé M, Loures L, Samb B. The UNAIDS 90-90-90 target: a clear choice for ending AIDS and for sustainable health and development. J Int AIDS Soc 2016; 19:21133 [View Article][PubMed]
     [Google Scholar]
  9. Barennes H, Virak K, Rouet F, Buisson Y, Strobel M et al. Factors associated with the failure of first and second-line antiretroviral therapies therapy, a case control study in Cambodian HIV-1 infected children. BMC Res Notes 2016; 9:69 [View Article][PubMed]
     [Google Scholar]
  10. Mulu A, Liebert UG, Maier M. Virological efficacy and immunological recovery among Ethiopian HIV-1 infected adults and children. BMC Infect Dis 2014; 14:28 [View Article][PubMed]
     [Google Scholar]
  11. Bangsberg DR. Preventing HIV antiretroviral resistance through better monitoring of treatment adherence. J Infect Dis 2008; 197:S272–S278 [View Article][PubMed]
     [Google Scholar]
  12. Gilks CF, Crowley S, Ekpini R, Gove S, Perriens J et al. The WHO public-health approach to antiretroviral treatment against HIV in resource-limited settings. Lancet 2006; 368:505–510 [View Article][PubMed]
     [Google Scholar]
  13. Botros BA, Aliyev QM, Saad MD, Michael AA, Sanchez JL et al. HIV infection and associated risk factors among long-distance truck drivers travelling through Azerbaijan. Int J STD AIDS 2009; 20:477–482 [View Article][PubMed]
     [Google Scholar]
  14. Azuonwu O, Erhabor O, Frank-Peterside N. HIV infection in long-distance truck drivers in a low income setting in the Niger Delta of Nigeria. J Community Health 2011; 36:583–587 [View Article][PubMed]
     [Google Scholar]
  15. Delany-Moretlwe S, Bello B, Kinross P, Oliff M, Chersich M et al. HIV prevalence and risk in long-distance truck drivers in South Africa: a national cross-sectional survey. Int J STD AIDS 2014; 25:428–438 [View Article][PubMed]
     [Google Scholar]
  16. Ghana Country AIDS Progress Report, Reporting period January 2010–December 2011. http://files.unaids.org/en/dataanalysis/knowyourresponse/countryprogressreports/2012countries/ce_GH_Narrative_Report.pdf Accessed 12 September 2017
  17. Barnor JS, Yamamoto N, Brandful JAM, Ampofo WK, Bonney JHK et al. Establishment of in-house quantitative real-time RT-PCR assay for HIV-1 viral load measurement. Application to evaluate efficacy of ART in Ghanaian patients in an urban setting. J AIDS Clin Res 2014; 5:305 [View Article]
     [Google Scholar]
  18. Nii-Trebi NI, Ibe S, Barnor JS, Ishikawa K, Brandful JA et al. HIV-1 drug-resistance surveillance among treatment-experienced and -naïve patients after the implementation of antiretroviral therapy in Ghana. PLoS One 2013; 8:e71972 [View Article][PubMed]
     [Google Scholar]
  19. IAS-USA 2017 Update of the Drug Resistance Mutations in HIV-1. www.iasusa.org/tam/article/2017-update-drug-resistance-mutations-hiv-1 Accessed 15 September 2017
  20. HIV Circulating Recombinant Forms (CRFs). www.hiv.lanl.gov/content/sequence/HIV/CRFs/CRFs.html Accessed 15 September 2017
  21. Meloni ST, Kim B, Sankalé JL, Hamel DJ, Tovanabutra S et al. Distinct human immunodeficiency virus type 1 subtype A virus circulating in West Africa: sub-subtype A3. J Virol 2004; 78:12438–12445 [View Article][PubMed]
     [Google Scholar]
  22. Vidal N, Mulanga C, Bazepeo SE, Lepira F, Delaporte E et al. Identification and molecular characterization of subsubtype A4 in central Africa. AIDS Res Hum Retroviruses 2006; 22:182–187 [View Article][PubMed]
     [Google Scholar]
  23. Kumar S, Stecher G, Tamura K. MEGA7: molecular evolutionary genetics analysis Version 7.0 for bigger datasets. Mol Biol Evol 2016; 33:1870–1874 [View Article][PubMed]
     [Google Scholar]
  24. Lole KS, Bollinger RC, Paranjape RS, Gadkari D, Kulkarni SS et al. Full-length human immunodeficiency virus type 1 genomes from subtype C-infected seroconverters in India, with evidence of intersubtype recombination. J Virol 1999; 73:152–160[PubMed]
     [Google Scholar]
  25. Fischetti L, Opare-Sem O, Candotti D, Sarkodie F, Lee H et al. Molecular epidemiology of HIV in Ghana: dominance of CRF02_AG. J Med Virol 2004; 73:158–166 [View Article][PubMed]
     [Google Scholar]
  26. Sagoe KW, Dwidar M, Adiku TK, Arens MQ. HIV-1 CRF 02 AG polymerase genes in Southern Ghana are mosaics of different 02 AG strains and the protease gene cannot infer subtypes. Virol J 2009; 6:27 [View Article][PubMed]
     [Google Scholar]
  27. Delgado E, Ampofo WK, Sierra M, Torpey K, Pérez-Alvarez L et al. High prevalence of unique recombinant forms of HIV-1 in Ghana: molecular epidemiology from an antiretroviral resistance study. J Acquir Immune Defic Syndr 2008; 48:599–606 [View Article][PubMed]
     [Google Scholar]
  28. Nii-Trebi NI, Barnor JS, Musah BO, Ampofo WK. Epidemiologic dominance of HIV-1 subtype CRF02_AG in Ghana. Preliminary virological evidence of increasing association with new infections. IJVSR 201322–28
     [Google Scholar]
  29. Fonjungo PN, Kalish ML, Schaefer A, Rayfield M, Mika J et al. Recombinant viruses initiated the early HIV-1 epidemic in Burkina Faso. PLoS One 2014; 9:e92423 [View Article][PubMed]
     [Google Scholar]
  30. Sylla M, Chamberland A, Boileau C, Traoré HA, Ag-Aboubacrine S et al. Characterization of drug resistance in antiretroviral-treated patients infected with HIV-1 CRF02_AG and AGK subtypes in Mali and Burkina Faso. Antivir Ther 2008; 13:141–148[PubMed]
     [Google Scholar]
  31. Takehisa J, Osei-Kwasi M, Ayisi NK, Hishida O, Miura T et al. Phylogenetic analysis of human immunodeficiency virus 1 in Ghana. Acta Virol 1997; 41:51–54[PubMed]
     [Google Scholar]
  32. Candotti D, Adu-Sarkodie Y, Davies F, Baldrich-Rubio E, Stirrups K et al. AIDS in an HIV-seronegative Ghanaian woman with intersubtype A/G recombinant HIV-1 infection. J Med Virol 2000; 62:1–8 [View Article][PubMed]
     [Google Scholar]
  33. Ahoua L, Guenther G, Pinoges L, Anguzu P, Chaix ML et al. Risk factors for virological failure and subtherapeutic antiretroviral drug concentrations in HIV-positive adults treated in rural northwestern Uganda. BMC Infect Dis 2009; 9:81 [View Article][PubMed]
     [Google Scholar]
  34. Salou M, Dagnra AY, Butel C, Vidal N, Serrano L et al. High rates of virological failure and drug resistance in perinatally HIV-1-infected children and adolescents receiving lifelong antiretroviral therapy in routine clinics in Togo. J Int AIDS Soc 2016; 19:20683 [View Article][PubMed]
     [Google Scholar]
  35. Vandormael AM, Boulware DR, Tanser FC, Bärnighausen TW, Stott KE et al. Brief Report: virologic monitoring can be a cost-effective strategy to diagnose treatment failure on first-line ART. J Acquir Immune Defic Syndr 2016; 71:462–466 [View Article][PubMed]
     [Google Scholar]
  36. Johannessen A, Naman E, Kivuyo SL, Kasubi MJ, Holberg-Petersen M et al. Virological efficacy and emergence of drug resistance in adults on antiretroviral treatment in rural Tanzania. BMC Infect Dis 2009; 9:81 [View Article][PubMed]
     [Google Scholar]
  37. Sigaloff KC, Calis JC, Geelen SP, van Vugt M, de Wit TF. HIV-1-resistance-associated mutations after failure of first-line antiretroviral treatment among children in resource-poor regions: a systematic review. Lancet Infect Dis 2011; 11:769–779 [View Article][PubMed]
     [Google Scholar]
  38. Hamers RL, Schuurman R, Sigaloff KC, Wallis CL, Kityo C et al. Effect of pretreatment HIV-1 drug resistance on immunological, virological, and drug-resistance outcomes of first-line antiretroviral treatment in sub-Saharan Africa: a multicentre cohort study. Lancet Infect Dis 2012; 12:307–317 [View Article][PubMed]
     [Google Scholar]
  39. Gupta RK, Jordan MR, Sultan BJ, Hill A, Davis DH et al. Global trends in antiretroviral resistance in treatment-naive individuals with HIV after rollout of antiretroviral treatment in resource-limited settings: a global collaborative study and meta-regression analysis. Lancet 2012; 380:1250–1258 [View Article][PubMed]
     [Google Scholar]
  40. Hamers RL, Wallis CL, Kityo C, Siwale M, Mandaliya K et al. HIV-1 drug resistance in antiretroviral-naive individuals in sub-Saharan Africa after rollout of antiretroviral therapy: a multicentre observational study. Lancet Infect Dis 2011; 11:750–759 [View Article][PubMed]
     [Google Scholar]
  41. Keiser O, Anastos K, Schechter M, Balestre E, Myer L et al. Antiretroviral therapy in resource-limited settings 1996 to 2006: patient characteristics, treatment regimens and monitoring in sub-Saharan Africa, Asia and Latin America. Trop Med Int Health 2008; 13:870–879 [View Article][PubMed]
     [Google Scholar]
  42. Tenkorang EY, Owusu AY. Examining HIV-related stigma and discrimination in Ghana: what are the major contributors?. Sex Health 2013; 10:253–262 [View Article][PubMed]
     [Google Scholar]
  43. Ghana Multiple Indicator Cluster Survey 2011 FR262. www.unicef.org/ghana/Ghana_MICS_Final.pdf Accessed 15 September 2017
  44. Hamers RL, Sigaloff KC, Wensing AM, Wallis CL, Kityo C et al. Patterns of HIV-1 drug resistance after first-line antiretroviral therapy (ART) failure in 6 sub-Saharan African countries: implications for second-line ART strategies. Clin Infect Dis 2012; 54:1660–1669 [View Article][PubMed]
     [Google Scholar]
  45. Sethi AK, Celentano DD, Gange SJ, Moore RD, Gallant JE. Association between adherence to antiretroviral therapy and human immunodeficiency virus drug resistance. Clin Infect Dis 2003; 37:1112–1118 [View Article][PubMed]
     [Google Scholar]
  46. Pacold M, Smith D, Little S, Cheng PM, Jordan P et al. Comparison of methods to detect HIV dual infection. AIDS Res Hum Retroviruses 2010; 26:1291–1298 [View Article][PubMed]
     [Google Scholar]
  47. Sigaloff KC, Ramatsebe T, Viana R, de Wit TF, Wallis CL et al. Accumulation of HIV drug resistance mutations in patients failing first-line antiretroviral treatment in South Africa. AIDS Res Hum Retroviruses 2012; 28:171–175 [View Article][PubMed]
     [Google Scholar]
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Dynamic HIV-1 genetic recombination and genotypic drug resistance among treatment-experienced adults in northern Ghana
J. Med. Microbiol. 66, 1663 (2017); https://doi.org/10.1099/jmm.0.000621
/content/journal/jmm/10.1099/jmm.0.000621
/content/journal/jmm/10.1099/jmm.0.000621
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