TY - JOUR
T1 - High prevalence of unique recombinant forms of HIV-1 in Ghana
T2 - Molecular epidemiology from an antiretroviral resistance study
AU - Delgado, Elena
AU - Ampofo, William Kwabena
AU - Sierra, María
AU - Torpey, Kwasi
AU - Pérez-Álvarez, Lucía
AU - Bonney, Evelyn Yayra
AU - Mukadi, Ya Diul
AU - Lartey, Margaret
AU - Nyarko, Charles
AU - Amenyah, Richard Noamesi
AU - Thomson, Michael M.
AU - Nájera, Rafael
PY - 2008/8/15
Y1 - 2008/8/15
N2 - BACKGROUND: In Ghana, programs to expand antiretroviral access are being implemented. In this context, the dynamic genetic evolution of HIV-1 requires continuous surveillance, particularly when diverse genetic forms co-circulate. METHODS:: Phylogenetic and antiretroviral resistance analyses of HIV-1 partial pol sequences from plasma RNA samples from 207 Ghanaian individuals were performed. RESULTS:: 66% of infections were CRF02-AG, whereas 25% were unique recombinant forms (URFs). All 52 URFs were characterized by bootscanning. CRF02-AG was parental strain in 87% of URFs, forming recombinants with genetic forms circulating in minor proportions: CRF06-cpx, sub-subtype A3, CRF09-cpx and subtypes G and D. Two triple recombinants (CRF02-AG/A3/CRF06-cpx and CRF02-AG/A3/CRF09-cpx) were identified. Antiretroviral resistance analyses revealed that six individuals, five of which were antiretroviral drug-experienced, harbored mutations conferring high level of resistance to reverse transcriptase inhibitors. No major resistance mutations were identified in the protease, although insertions of one and three amino acids were detected. CONCLUSIONS:: The high frequency of URFs detected probably reflects a significant incidence of coinfections or superinfections with diverse viral strains, which increases the genetic complexity of the HIV-1 epidemic in West Africa. Monitoring of HIV-1 drug resistance might provide data on the implications of intersubtype recombination in response to antiretrovirals.
AB - BACKGROUND: In Ghana, programs to expand antiretroviral access are being implemented. In this context, the dynamic genetic evolution of HIV-1 requires continuous surveillance, particularly when diverse genetic forms co-circulate. METHODS:: Phylogenetic and antiretroviral resistance analyses of HIV-1 partial pol sequences from plasma RNA samples from 207 Ghanaian individuals were performed. RESULTS:: 66% of infections were CRF02-AG, whereas 25% were unique recombinant forms (URFs). All 52 URFs were characterized by bootscanning. CRF02-AG was parental strain in 87% of URFs, forming recombinants with genetic forms circulating in minor proportions: CRF06-cpx, sub-subtype A3, CRF09-cpx and subtypes G and D. Two triple recombinants (CRF02-AG/A3/CRF06-cpx and CRF02-AG/A3/CRF09-cpx) were identified. Antiretroviral resistance analyses revealed that six individuals, five of which were antiretroviral drug-experienced, harbored mutations conferring high level of resistance to reverse transcriptase inhibitors. No major resistance mutations were identified in the protease, although insertions of one and three amino acids were detected. CONCLUSIONS:: The high frequency of URFs detected probably reflects a significant incidence of coinfections or superinfections with diverse viral strains, which increases the genetic complexity of the HIV-1 epidemic in West Africa. Monitoring of HIV-1 drug resistance might provide data on the implications of intersubtype recombination in response to antiretrovirals.
KW - Antiretroviral resistance
KW - Ghana
KW - HIV-1
KW - Recombinant
KW - Subtype
UR - http://www.scopus.com/inward/record.url?scp=50949104038&partnerID=8YFLogxK
U2 - 10.1097/QAI.0b013e3181806c0e
DO - 10.1097/QAI.0b013e3181806c0e
M3 - Article
C2 - 18645511
AN - SCOPUS:50949104038
SN - 1525-4135
VL - 48
SP - 599
EP - 606
JO - Journal of Acquired Immune Deficiency Syndromes
JF - Journal of Acquired Immune Deficiency Syndromes
IS - 5
ER -