HIV‐1 drug resistance among antiretroviral treatment‐naïve Ethiopian patients
In: Journal of the International AIDS Society, Band 15, Heft S4, S. 1-1
ISSN: 1758-2652
BackgroundIn many African countries, access to antiretroviral treatment (ART) has been significantly scaled up over the last five years. Nevertheless, data on drug resistance mutation are scarce. The objective of the current study was to determine the predominant subtypes of HIV‐1 as well as to identify baseline mutations with potential drug resistance among ART‐naïve patients from Ethiopia.MethodsGenotypic drug resistance on the entire protease and partial reverse transcriptase (codons 1–335) regions of the pol gene was determined by an in‐house protocol in 160 ART‐naïve patients. Genotypic drug resistance was defined as the presence of one or more resistance‐related mutations, as specified by the consensus of the Stanford University HIV drug resistance database (HIVDB) available at http://hivdb.stanford.edu/ and the 2011 International AIDS Society (IAS) mutation list (http://www.iasusa.org/resistance‐mutations/).ResultsA predominance of HIV‐1 subtype C (98.7%) was observed. According to the IAS mutation list, antiretroviral drug resistance mutations were detected in 20 patients (13%). However, the level of drug resistance is 5.2% (8/155) when the most conservative method, HIVDB algorithms were applied. In both algorithms, none had major PI mutation and mutation‐conferring resistance to NRTI and NNRTI were not overlapping.ConclusionsThere is strong evidence for clade homogeneity in Ethiopia and low influx of other subtypes to the country. The level of transmitted drug resistance exceeds that of WHO estimates and indicates that many HIV‐infected individuals on ART are practicing risk‐related behaviours. The results also show that HIV drug resistance testing should be installed in resource limited settings.