OBJECTIVE: To characterize HIV-1 phenotypic resistance patterns and genotypic mutations among patients taking antiretroviral medications in Uganda. METHODS: We reviewed charts and retrieved archived plasma specimens from patients at an AIDS specialty center in Uganda where antiretroviral therapy has been used since 1996. Phenotypic and genotypic resistance testing was done on specimens associated with a viral load of 1000 copies/ml. RESULTS: Resistance testing of specimens was completed for 16 patients. Among 11 specimens collected before initiation of antiretroviral therapy, no phenotypic resistance or primary genotypic mutations were found. Among 8 patients taking lamivudine, phenotypic resistance was found for 9 (90%) of 10 specimens and was associated with an M184V mutation in all nine cases. Among 12 patients taking zidovudine, no phenotypic resistance and few primary mutations were found. For 6 patients who were receiving protease inhibitors, we observed no phenotypic resistance and only one primary genotypic mutation associated with resistance. CONCLUSIONS: The absence of apparent resistance among samples collected before antiretroviral therapy supports the notion that a similar approach to selection of antiretroviral therapy can generally be used against non-B subtypes. A genotypic marker of antiretroviral resistance to lamivudine in HIV-1 subtypes A, C, and D was similar to those in subtype B infections. These results suggest that the methods used for monitoring for the emergence of drug resistance in antiretroviral programs in Africa may be similar to those used in developed settings.
OBJECTIVE: To characterize HIV-1 phenotypic resistance patterns and genotypic mutations among patients taking antiretroviral medications in Uganda. METHODS: We reviewed charts and retrieved archived plasma specimens from patients at an AIDS specialty center in Uganda where antiretroviral therapy has been used since 1996. Phenotypic and genotypic resistance testing was done on specimens associated with a viral load of 1000 copies/ml. RESULTS: Resistance testing of specimens was completed for 16 patients. Among 11 specimens collected before initiation of antiretroviral therapy, no phenotypic resistance or primary genotypic mutations were found. Among 8 patients taking lamivudine, phenotypic resistance was found for 9 (90%) of 10 specimens and was associated with an M184V mutation in all nine cases. Among 12 patients taking zidovudine, no phenotypic resistance and few primary mutations were found. For 6 patients who were receiving protease inhibitors, we observed no phenotypic resistance and only one primary genotypic mutation associated with resistance. CONCLUSIONS: The absence of apparent resistance among samples collected before antiretroviral therapy supports the notion that a similar approach to selection of antiretroviral therapy can generally be used against non-B subtypes. A genotypic marker of antiretroviral resistance to lamivudine in HIV-1 subtypes A, C, and D was similar to those in subtype B infections. These results suggest that the methods used for monitoring for the emergence of drug resistance in antiretroviral programs in Africa may be similar to those used in developed settings.
Authors: Ryan J Morrow; A David Woolfson; Louise Donnelly; Rhonda Curran; Gavin Andrews; Dietmar Katinger; R Karl Malcolm Journal: Eur J Pharm Biopharm Date: 2010-11-03 Impact factor: 5.571
Authors: Peter N Fonjungo; Eitel N Mpoudi; Judith N Torimiro; George A Alemnji; Laura T Eno; Esther J Lyonga; John N Nkengasong; Renu B Lal; Mark Rayfield; Marcia L Kalish; Thomas M Folks; Danuta Pieniazek Journal: J Clin Microbiol Date: 2002-03 Impact factor: 5.948
Authors: Susan H Eshleman; Oliver Laeyendecker; Neil Parkin; Wei Huang; Colombe Chappey; Agnes C Paquet; David Serwadda; Steven J Reynolds; Noah Kiwanuka; Thomas C Quinn; Ronald Gray; Maria Wawer Journal: AIDS Date: 2009-04-27 Impact factor: 4.177
Authors: Hakim Sendagire; Philippa J Easterbrook; Immaculate Nankya; Eric Arts; David Thomas; Steven J Reynolds Journal: AIDS Rev Date: 2009 Apr-Jun Impact factor: 2.500
Authors: Balthazar M Nyombi; Carol Holm-Hansen; Knut I Kristiansen; Gunnar Bjune; Fredrik Müller Journal: AIDS Res Ther Date: 2008-06-21 Impact factor: 2.250