Antiretroviral Resistance in HIV-Infected Persons at Virological Failure in Côte D’ivoire, West Africa (Published)
The selection of resistance mutations is one of the main consequences of virological failure. The objective of our study was to determine the resistance profile of HIV-1 to ARVs and molecular phylogeny in patients treated with virological failure in Côte d’Ivoire. The genotypic resistance testing (GRT) were performed and interpreted according to the ANRS algorithm (www.hivfrenchresistance.org). Phylogenetic trees were created using BioEdit v7 and Mega7 software. Phylogenetic analysis showed that CRF02_AG (83%) was the most represented. Also noted are the circulation of subtype A (9%), B (2%), C (1%), D (1%) and complex recombinants CRF02/A1 (1%), CRF02/CRF09 (1%), CRF09_cpx (2%), CRF06_cpx (2%). The frequency of resistance to at least one ARV molecule was 74%. It was 87% for nucleoside reverse transcriptase inhibitors (NRTIs), 81% for non-nucleoside reverse transcriptase inhibitors (NNRTIs) and 37% for protease inhibitors (PIs). The resistance frequency at two classes was 45% and 12% respectively at NRTIs/NNRTIs and NRTIs/PIs. The frequency of resistance to all three classes (NRTIs /NNRTIs/PIs) was 24%. Frequently encountered resistance mutations were for NRTIs: M184V (88%), “thymidine analogue mutations” (23%); for NNRTIs: K103N (65%). As for PIs, resistance to lopinavir/ritonavir, atazanavir/ritonavir and darunavir/ritonavir were 78%, 57% and 14% of PIs resistance, respectively. The analyses showed a high prevalence of resistance in patients in therapeutic failure followed routinely. These data support more accessible monitoring for the viral load and GRT in subjects treated for therapeutic failure.