TY - JOUR
T1 - Molecular Epidemiology of HIV-1 in Ghana
T2 - Subtype Distribution, Drug Resistance and Coreceptor Usage
AU - Appah, Anna
AU - Beelen, Charlotte J.
AU - Kirkby, Don
AU - Dong, Winnie
AU - Shahid, Aniqa
AU - Foley, Brian
AU - Mensah, Miriam
AU - Ganu, Vincent
AU - Puplampu, Peter
AU - Amoah, Linda E.
AU - Nii-Trebi, Nicholas I.
AU - Brumme, Chanson J.
AU - Brumme, Zabrina L.
N1 - Publisher Copyright:
© 2022 by the authors.
PY - 2023/1
Y1 - 2023/1
N2 - The greatest HIV-1 genetic diversity is found in West/Central Africa due to the pandemic’s origins in this region, but this diversity remains understudied. We characterized HIV-1 subtype diversity (from both sub-genomic and full-genome viral sequences), drug resistance and coreceptor usage in 103 predominantly (90%) antiretroviral-naive individuals living with HIV-1 in Ghana. Full-genome HIV-1 subtyping confirmed the circulating recombinant form CRF02_AG as the dominant (53.9%) subtype in the region, with the complex recombinant 06_cpx (4%) present as well. Unique recombinants, most of which were mosaics containing CRF02_AG and/or 06_cpx, made up 37% of sequences, while “pure” subtypes were rare (<6%). Pretreatment resistance to at least one drug class was observed in 17% of the cohort, with NNRTI resistance being the most common (12%) and INSTI resistance being relatively rare (2%). CXCR4-using HIV-1 sequences were identified in 23% of participants. Overall, our findings advance our understanding of HIV-1 molecular epidemiology in Ghana. Extensive HIV-1 genetic diversity in the region appears to be fueling the ongoing creation of novel recombinants, the majority CRF02_AG-containing, in the region. The relatively high prevalence of pretreatment NNRTI resistance but low prevalence of INSTI resistance supports the use of INSTI-based first-line regimens in Ghana.
AB - The greatest HIV-1 genetic diversity is found in West/Central Africa due to the pandemic’s origins in this region, but this diversity remains understudied. We characterized HIV-1 subtype diversity (from both sub-genomic and full-genome viral sequences), drug resistance and coreceptor usage in 103 predominantly (90%) antiretroviral-naive individuals living with HIV-1 in Ghana. Full-genome HIV-1 subtyping confirmed the circulating recombinant form CRF02_AG as the dominant (53.9%) subtype in the region, with the complex recombinant 06_cpx (4%) present as well. Unique recombinants, most of which were mosaics containing CRF02_AG and/or 06_cpx, made up 37% of sequences, while “pure” subtypes were rare (<6%). Pretreatment resistance to at least one drug class was observed in 17% of the cohort, with NNRTI resistance being the most common (12%) and INSTI resistance being relatively rare (2%). CXCR4-using HIV-1 sequences were identified in 23% of participants. Overall, our findings advance our understanding of HIV-1 molecular epidemiology in Ghana. Extensive HIV-1 genetic diversity in the region appears to be fueling the ongoing creation of novel recombinants, the majority CRF02_AG-containing, in the region. The relatively high prevalence of pretreatment NNRTI resistance but low prevalence of INSTI resistance supports the use of INSTI-based first-line regimens in Ghana.
KW - Ghana
KW - HIV
KW - HIV-1
KW - coreceptor usage
KW - molecular epidemiology
KW - pretreatment drug resistance
KW - subtype diversity
UR - http://www.scopus.com/inward/record.url?scp=85147046310&partnerID=8YFLogxK
U2 - 10.3390/v15010128
DO - 10.3390/v15010128
M3 - Article
C2 - 36680168
AN - SCOPUS:85147046310
SN - 1999-4915
VL - 15
JO - Viruses
JF - Viruses
IS - 1
M1 - 128
ER -