High prevalence of unique recombinant forms of HIV-1 in Ghana: Molecular epidemiology from an antiretroviral resistance study

Elena Delgado, William Kwabena Ampofo, María Sierra, Kwasi Torpey, Lucía Pérez-Álvarez, Evelyn Yayra Bonney, Ya Diul Mukadi, Margaret Lartey, Charles Nyarko, Richard Noamesi Amenyah, Michael M. Thomson, Rafael Nájera

Research output: Contribution to journalArticlepeer-review

30 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)599-606
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume48
Issue number5
DOIs
Publication statusPublished - 15 Aug 2008
Externally publishedYes

Keywords

  • Antiretroviral resistance
  • Ghana
  • HIV-1
  • Recombinant
  • Subtype

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