Drug resistance mutations against protease, reverse transcriptase and integrase inhibitors in people living with HIV-1 receiving boosted protease inhibitors in South Africa

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dc.contributor.authorObasa, Adetayo Emmanuelen_ZA
dc.contributor.authorMikasi, Sello Givenen_ZA
dc.contributor.authorBrado, Dominiken_ZA
dc.contributor.authorCloete, Rubenen_ZA
dc.contributor.authorSingh, Kamlendraen_ZA
dc.contributor.authorNeogi, Ujjwalen_ZA
dc.contributor.authorJacobs, Graeme Brendonen_ZA
dc.date.accessioned2020-06-09T15:05:24Z
dc.date.available2020-06-09T15:05:24Z
dc.date.issued2020
dc.descriptionCITATION: Obasa, A. E., et al. 2020. Drug resistance mutations against protease, reverse transcriptase and integrase inhibitors in people living with HIV-1 receiving boosted protease inhibitors in South Africa. Frontiers in Microbiology, 11:438, doi:10.3389/fmicb.2020.00438.
dc.descriptionThe original publication is available at https://www.frontiersin.org
dc.descriptionPublication of this article was funded by the Stellenbosch University Open Access Fund
dc.description.abstractThe South African national combination antiretroviral therapy (cART) roll-out program started in 2006, with over 4.4 million people accessing treatment since it was first introduced. HIV-1 drug resistance can hamper the success of cART. This study determined the patterns of HIV-1 drug-resistance associated mutations (RAMs) in People Living with HIV-1 (PLHIV-1). Receiving first (for children below 3 years of age) and second-line (for adults) cART regimens in South Africa. During 2017 and 2018, 110 patients plasma samples were selected, 96 samples including those of 17 children and infants were successfully analyzed. All patients were receiving a boosted protease inhibitor (bPI) as part of their cART regimen. The viral sequences were analyzed for RAMs through genotypic resistance testing. We performed genotypic resistance testing (GRT) for Protease inhibitors (PIs), Reverse transcriptase inhibitors (RTIs) and Integrase strand transfer inhibitors (InSTIs). Viral sequences were subtyped using REGAv3 and COMET. Based on the PR/RT sequences, HIV-1 subtypes were classified as 95 (99%) HIV-1 subtype C (HIV-1C) while one sample as 02_AG. Integrase sequencing was successful for 89 sequences, and all the sequences were classified as HIV-1C (99%, 88/89) except one sequence classified CRF02_AG, as observed in PR/RT. Of the 96 PR/RT sequences analyzed, M184V/I (52/96; 54%) had the most frequent RAM nucleoside reverse transcriptase inhibitor (NRTI). The most frequent non-nucleoside reverse transcriptase inhibitor (NNRTI) RAM was K103N/S (40/96, 42%). Protease inhibitor (PI) RAMs M46I and V82A were present in 12 (13%) of the sequences analyzed. Among the InSTI major RAM two (2.2%) sequences have Y143R and T97A mutations while one sample had T66I. The accessory RAM E157Q was identified in two (2.2%). The data indicates that the majority of the patients failed on bPIs didn’t have any mutation; therefore adherence could be major issue in these groups of individuals. We propose continued viral load monitoring for better management of infected PLHIV.en_ZA
dc.description.urihttps://www.frontiersin.org/articles/10.3389/fmicb.2020.00438/full
dc.description.versionPublisher's version
dc.format.extent9 pages ; illustrations
dc.identifier.citationObasa, A. E., et al. 2020. Drug resistance mutations against protease, reverse transcriptase and integrase inhibitors in people living with HIV-1 receiving boosted protease inhibitors in South Africa. Frontiers in Microbiology, 11:438, doi:10.3389/fmicb.2020.00438
dc.identifier.issn1664-302X (online)
dc.identifier.otherdoi:10.3389/fmicb.2020.00438
dc.identifier.urihttp://hdl.handle.net/10019.1/108651
dc.language.isoen_ZAen_ZA
dc.publisherFrontiers Media
dc.rights.holderAuthors retain copyright
dc.subjectDrug resistanceen_ZA
dc.subjectHIV-positive persons -- South Africaen_ZA
dc.subjectProtease inhibitorsen_ZA
dc.subjectAntiretroviral agentsen_ZA
dc.titleDrug resistance mutations against protease, reverse transcriptase and integrase inhibitors in people living with HIV-1 receiving boosted protease inhibitors in South Africaen_ZA
dc.typeArticleen_ZA
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