AEGiS-13IAC: High prevalence of genotypic and phenotypic antiretroviral (ARV) drug resistant HIV-1 strains among patients receiving ARV in Abidjan, Cote d'Ivoire.

13th International AIDS Conference

Durban, South Africa - July 9-July 14, 2000

High prevalence of genotypic and phenotypic antiretroviral (ARV) drug resistant HIV-1 strains among patients receiving ARV in Abidjan, Cote d'Ivoire.

Int Conf AIDS 2000 Jul 9-14; 13:(abstract no. TuOrB298)

Adje C, Cheingsong Popov R, Roels W, Verbiest W, Djomand G, Hertogs K, Larder B, Monga B, Peeters M
C. Adje, Project Retro-CI, 01 PO Box 1712, Abidjan 01, Cote D'ivoire, Tel.: +225 212 54 111, Fax: +225 212 429 69, E-mail: cia9@cdc.gov

OBJECTIVE: To determine the prevalence of ARV drug-resistant HIV-1 strains among patients treated with ARV in Cote d'Ivoire.

METHODS: We selected all patients (n = 68) with a history of current or past ARV therapy who presented between August 1998 and April 1999 for inclusion in the UNAIDS-sponsored Drug Access Initiative. HIV-1 plasma viral load (VL) was quantified by the Amplicor HIV-1 Monitor test, CD4+ T cell counts by FACsan flow cytometry, genotypic drug resistance by sequencing (Clipp, Visible Genetics), and phenotypic resistance by a recombinant virus assay technology (antivirogram, Virco). HIV-1 subtypes were analyzed in a phylogenetic tree.

RESULTS: Median (interquartile range) age of the 68 patients was 38 years (31-44), CD4+ T cell count was 211 cells/m L (66-373), and viral load was 4.8 log₁₀ copies/mL (3.8-5.3). Of the 67 patients assessed for genetic subtypes, 70% were IBNG-recombinants, 15% subtype A, 4.4% subtype D, 4.4% subtype G, 1.5% subtype H, and 4.4% were unclassifiable. Of the 68 patients, 39 (57%) had genotypic resistance to at least one reverse transcriptase inhibitor (RTI) or protease inhibitor (PI). Median VL was similar for patients with resistant strains (4.8 log₁₀ copies/mL [2.6-6.2]) and those without resistant strains (4.7 log₁₀ copies/mL [2.6-6.1]) (p = 0.94). Resistant mutations were found for ZDV in 29 (43%) patients, 3TC 10 (15%), Nevirapine 1 (2%), DMP266 1 (2%), Indinavir 2 (3%), Ritonavir 2 (3%), and Nelfinavir 1 (2%). Phenotypic resistance to at least one nucleoside RTI was seen in 25 (40%) patients, 5 (8%) to non-nucleoside RTIs, and 4 (6%) to PIs. Concordance between phenotyping and genotyping results ranged from 76% for ZDV to 98% for Ritonavir.

CONCLUSIONS: Our results indicate that ARV drug resistance is common among patients in Abidjan with a history of ARV therapy and that this resistance among patients with non-subtype B infections is conferred by similar mutations to those documented for subtype B infections.

Keywords: AEGIS, HIV-1, Prevalence, Reverse Transcriptase Inhibitors, Viral Load, HIV-1 Reverse Transcriptase, CD4 Lymphocyte Count, Nelfinavir, Indinavir, Genotype, Mutation, Zidovudine, Ritonavir, Pharmaceutical Preparations, Cote d'Ivoire, Human, genetics
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TuOrB298