Evolution of primary HIV drug resistance in a subtype C dominated epidemic in Mozambique.
In Mozambique, highly active antiretroviral treatment (HAART) was introduced in 2004 followed by decentralization and expansion, resulting in a more than 20-fold increase in coverage by 2009. Implementation of HIV drug resistance threshold surveys (HIVDR-TS) is crucial in order to monitor the emerge...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2013-01-01
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| Series: | PLoS ONE |
| Online Access: | http://europepmc.org/articles/PMC3728366?pdf=render |
| _version_ | 1818159325374316544 |
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| author | Dulce Celina Adolfo Bila Peter Young Harriet Merks Adolfo Salvador Vubil Mussagy Mahomed Angelo Augusto Celina Monteiro Abreu Nédio Jonas Mabunda James I Brooks Amilcar Tanuri Ilesh Vinodrai Jani |
| author_facet | Dulce Celina Adolfo Bila Peter Young Harriet Merks Adolfo Salvador Vubil Mussagy Mahomed Angelo Augusto Celina Monteiro Abreu Nédio Jonas Mabunda James I Brooks Amilcar Tanuri Ilesh Vinodrai Jani |
| author_sort | Dulce Celina Adolfo Bila |
| collection | DOAJ |
| description | In Mozambique, highly active antiretroviral treatment (HAART) was introduced in 2004 followed by decentralization and expansion, resulting in a more than 20-fold increase in coverage by 2009. Implementation of HIV drug resistance threshold surveys (HIVDR-TS) is crucial in order to monitor the emergence of transmitted viral resistance, and to produce evidence-based recommendations to support antiretroviral (ARV) policy in Mozambique.World Health Organization (WHO) methodology was used to evaluate transmitted drug resistance (TDR) in newly diagnosed HIV-1 infected pregnant women attending ante-natal clinics in Maputo and Beira to non-nucleoside reverse transcriptase inhibitors (NNRTI), nucleoside reverse transcriptase inhibitors (NRTI) and protease inhibitors (PI). Subtypes were assigned using REGA HIV-1 subtyping tool and phylogenetic trees constructed using MEGA version 5.Although mutations associated with resistance to all three drug were detected in these surveys, transmitted resistance was analyzed and classified as <5% in Maputo in both surveys for all three drug classes. Transmitted resistance to NNRTI in Beira in 2009 was classified between 5-15%, an increase from 2007 when no NNRTI mutations were found. All sequences clustered with subtype C.Our results show that the epidemic is dominated by subtype C, where the first-line option based on two NRTI and one NNRTI is still effective for treatment of HIV infection, but intermediate levels of TDR found in Beira reinforce the need for constant evaluation with continuing treatment expansion in Mozambique. |
| first_indexed | 2024-12-11T15:44:11Z |
| format | Article |
| id | doaj.art-22b8beee6c99496080dd5589987c8f69 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-12-11T15:44:11Z |
| publishDate | 2013-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-22b8beee6c99496080dd5589987c8f692022-12-22T00:59:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032013-01-0187e6821310.1371/journal.pone.0068213Evolution of primary HIV drug resistance in a subtype C dominated epidemic in Mozambique.Dulce Celina Adolfo BilaPeter YoungHarriet MerksAdolfo Salvador VubilMussagy MahomedAngelo AugustoCelina Monteiro AbreuNédio Jonas MabundaJames I BrooksAmilcar TanuriIlesh Vinodrai JaniIn Mozambique, highly active antiretroviral treatment (HAART) was introduced in 2004 followed by decentralization and expansion, resulting in a more than 20-fold increase in coverage by 2009. Implementation of HIV drug resistance threshold surveys (HIVDR-TS) is crucial in order to monitor the emergence of transmitted viral resistance, and to produce evidence-based recommendations to support antiretroviral (ARV) policy in Mozambique.World Health Organization (WHO) methodology was used to evaluate transmitted drug resistance (TDR) in newly diagnosed HIV-1 infected pregnant women attending ante-natal clinics in Maputo and Beira to non-nucleoside reverse transcriptase inhibitors (NNRTI), nucleoside reverse transcriptase inhibitors (NRTI) and protease inhibitors (PI). Subtypes were assigned using REGA HIV-1 subtyping tool and phylogenetic trees constructed using MEGA version 5.Although mutations associated with resistance to all three drug were detected in these surveys, transmitted resistance was analyzed and classified as <5% in Maputo in both surveys for all three drug classes. Transmitted resistance to NNRTI in Beira in 2009 was classified between 5-15%, an increase from 2007 when no NNRTI mutations were found. All sequences clustered with subtype C.Our results show that the epidemic is dominated by subtype C, where the first-line option based on two NRTI and one NNRTI is still effective for treatment of HIV infection, but intermediate levels of TDR found in Beira reinforce the need for constant evaluation with continuing treatment expansion in Mozambique.http://europepmc.org/articles/PMC3728366?pdf=render |
| spellingShingle | Dulce Celina Adolfo Bila Peter Young Harriet Merks Adolfo Salvador Vubil Mussagy Mahomed Angelo Augusto Celina Monteiro Abreu Nédio Jonas Mabunda James I Brooks Amilcar Tanuri Ilesh Vinodrai Jani Evolution of primary HIV drug resistance in a subtype C dominated epidemic in Mozambique. PLoS ONE |
| title | Evolution of primary HIV drug resistance in a subtype C dominated epidemic in Mozambique. |
| title_full | Evolution of primary HIV drug resistance in a subtype C dominated epidemic in Mozambique. |
| title_fullStr | Evolution of primary HIV drug resistance in a subtype C dominated epidemic in Mozambique. |
| title_full_unstemmed | Evolution of primary HIV drug resistance in a subtype C dominated epidemic in Mozambique. |
| title_short | Evolution of primary HIV drug resistance in a subtype C dominated epidemic in Mozambique. |
| title_sort | evolution of primary hiv drug resistance in a subtype c dominated epidemic in mozambique |
| url | http://europepmc.org/articles/PMC3728366?pdf=render |
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