Pairwise and higher-order correlations among drug-resistance mutations in HIV-1 subtype B protease

The success of antiretroviral treatment (ART) is threatened by the emergence of drug resistance mutations (DRM). Since Brazil presents the largest number of people living with HIV (PLWH) in South America we aimed at understanding the dynamics of DRM in this country. We analyzed a total of 20,226 HIV-1 sequences collected from PLWH undergoing ART between 2008–2017. Results show a mild decline of DRM over the years but an increase of the K65R reverse transcriptase mutation from 2.23% to 12.11%. This increase gradually occurred following alterations in the ART regimens replacing zidovudine (AZT) with tenofovir (TDF). PLWH harboring the K65R had significantly higher viral loads than those without this mutation (p < 0.001). Among the two most prevalent HIV-1 subtypes (B and C) there was a significant (p < 0.001) association of K65R with subtype C (11.26%) when compared with subtype B (9.27%). Nonetheless, evidence for K65R transmission in Brazil was found both for C and B subtypes. Additionally, artificial neural network-based immunoinformatic predictions suggest that K65R could enhance viral recognition by HLA-B27 that has relatively low prevalence in the Brazilian population. Overall, the results suggest that tenofovir-based regimens need to be carefully monitored particularly in settings with subtype C and specific HLA profiles.

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Diversity of HIV-1 subtypes and transmitted drug-resistance mutations among minority HIV-1 variants in a Turkish cohort

Current HIV Research ◽

10.2174/1570162x19666211119111740 ◽

2021 ◽

Vol 19 ◽

Author(s):

Rabia Can Sarinoglu ◽

Uluhan Sili ◽

Ufuk Hasdemir ◽

Burak Aksu ◽

Guner Soyletir ◽

...

Keyword(s):

Drug Resistance ◽

Reverse Transcriptase ◽

Transcriptase Inhibitor ◽

Transmitted Drug Resistance ◽

Resistance Mutations ◽

Drug Resistance Mutations ◽

Subtype B ◽

Treatment Naïve ◽

Reverse Transcriptase Inhibitor ◽

Hiv 1

Background: The World Health Organization (WHO) recommends the surveillance of transmitted drug resistance mutations (TDRMs) to ensure the effectiveness and sustainability of HIV treatment programs. Objective: Our aim was to determine the TDRMs and evaluate the distribution of HIV-1 subtypes using and compared next-generation sequencing (NGS) and Sanger-based sequencing (SBS) in a cohort of 44 antiretroviral treatment-naïve patients. Methods: All samples that were referred to the microbiology laboratory for HIV drug resistance analysis between December 2016 and February 2018 were included in the study. After exclusions, 44 treatment-naive adult patients with a viral load of >1000 copies/mL were analyzed. DNA sequencing for reverse transcriptase and protease regions was performed using both DeepChek ABL single round kit and Sanger-based ViroSeq HIV-1 Genotyping System. The mutations and HIV-1 subtypes were analyzed using the Stanford HIVdb version 8.6.1 Genotypic Resistance software, and TDRMs were assessed using the WHO surveillance drug-resistance mutation database. HIV-1 subtypes were confirmed by constructing a maximum-likelihood phylogenetic tree using Los Alamos IQ-Tree software. Results: NGS identified nucleos(t)ide reverse transcriptase inhibitor (NRTI)-TDRMs in 9.1% of the patients, non-nucleos(t)ide reverse transcriptase inhibitor (NNRTI)-TDRMs in 6.8% of the patients, and protease inhibitor (PI)-TDRMs in 18.2% of the patients at a detection threshold of ≥1%. Using SBS, 2.3% and 6.8% of the patients were found to have NRTI- and NNRTI-TDRMs, respectively, but no major PI mutations were detected. M41L, L74I, K65R, M184V, and M184I related to NRTI, K103N to NNRTI, and N83D, M46I, I84V, V82A, L24I, L90M, I54V to the PI sites were identified using NGS. Most mutations were found in low-abundance (frequency range: 1.0% - 4.7%) HIV-1 variants, except M41L and K103N. The subtypes of the isolates were found as follows; 61.4% subtype B, 18.2% subtype B/CRF02_AG recombinant, 13.6% subtype A, 4.5% CRF43_02G, and 2.3% CRF02_AG. All TDRMs, except K65R, were detected in HIV-1 subtype B isolates.. Conclusion: The high diversity of protease site TDRMs in the minority HIV-1 variants and prevalence of CRFs were remarkable in this study. All minority HIV-1 variants were missed by conventional sequencing. TDRM prevalence among minority variants appears to be decreasing over time at our center.

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Transmitted drug resistance mutations and subtype diversity among HIV-1 sero-positive voluntary blood donors in Accra, Ghana

10.21203/rs.3.rs-21810/v1 ◽

2020 ◽

Author(s):

Billal Musah Obeng ◽

Evelyn Yayra Bonney ◽

Lucy Asamoah-Akuoko ◽

Nicholas Israel Nii-Trebi ◽

Gifty Mawuli ◽

...

Keyword(s):

Drug Resistance ◽

Blood Donors ◽

Transmitted Drug Resistance ◽

Nucleotide Sequencing ◽

Plasma Samples ◽

Resistance Mutations ◽

Drug Resistance Mutations ◽

Subtype B ◽

Major Drug ◽

Hiv 1

Abstract Background: Detection of HIV-1 transmitted drug resistance (TDR) and subtype diversity (SD) are public health strategies to assess current HIV-1 regimen and ensure effective therapeutic outcomes of ART among HIV-1 patients. Globally, limited data exist on TDR and SD among blood donors. In this study, drug resistance mutations and subtype diversity among HIV-1 sero-positive blood donors in Accra, Ghana was characterized.Methods: Purposive sampling method was used to collect 81 HIV sero-positive blood samples from the Southern Area Blood Center and confirmed by serology as HIV-1 and/or HIV-2. Viral RNA was only extracted from plasma samples confirmed as HIV-1 positive. Complementary DNA (cDNA) was synthesized using the RNA as a template and subsequently amplified by nested PCR with specific primers. The expected products were verified, purified and sequenced. Neighbor-joining tree with the Kimura’s 2-parameter distances was generated with the RT sequences using Molecular Evolutionary Genetic Analysis version 6.0 (MEGA 6.0).Results: Out of the 81 plasma samples, 60 (74%) were confirmed as HIV-1 sero-positive by INNO-LIA HIVI/II Score kit with no HIV-2 and dual HIV-1/2 infections. The remaining samples, 21 (26%) were confirmed as HIV sero-negative. Of the 60 confirmed positive samples, (32) 53% and (28) 50% were successfully amplified in the RT and PR genes respectively. Nucleotide sequencing of amplified samples revealed the presence of major drug resistance mutations in two (2) samples; E138A in one sample and another with K65R. HIV-1 Subtypes including subtypes A, B, CRF02_AG and CRF09_cpx were found. Conclusion: This study found major drug resistance mutations, E138A and K65R in the RT gene that confer high level resistance to most NNRTIs and NRTI respectively. CRF02_AG was most predominant, the recorded percentage of subtype B and the evolutionary relationship inferred by phylogenetic analysis suggest possible subtype importation. The data obtained would inform the selection of drugs for ART initiation to maximize therapeutic options in drug-naïve HIV-1 patients in Ghana.

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Silent mutations at codons 65 and 66 in reverse transcriptase alleviate indel formation and restore fitness in subtype B HIV-1 containing D67N and K70R drug resistance mutations

Nucleic Acids Research ◽

10.1093/nar/gkv128 ◽

2015 ◽

Vol 43 (6) ◽

pp. 3256-3271 ◽

Cited By ~ 6

Author(s):

Sushama Telwatte ◽

Anna C. Hearps ◽

Adam Johnson ◽

Catherine F. Latham ◽

Katie Moore ◽

...

Keyword(s):

Drug Resistance ◽

Reverse Transcriptase ◽

Resistance Mutations ◽

Drug Resistance Mutations ◽

Subtype B ◽

Hiv 1

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MOLECULAR-EPIDEMIOLOGICAL CHARACTERISTICS OF HIV1 VARIANTS CIRCULATING IN THE JEWISH AUTONOMOUS REGION TERRITORY

HIV Infection and Immunosuppressive Disorders ◽

10.22328/2077-9828-2018-10-4-90-99 ◽

2019 ◽

Vol 10 (4) ◽

pp. 90-99 ◽

Cited By ~ 1

Author(s):

V. O. Kotova ◽

O. E. Trotsenko ◽

L. A. Balakhontseva ◽

E. A. Bazykina ◽

O. A. Yanovich ◽

...

Keyword(s):

Drug Resistance ◽

Resistance Mutations ◽

Prevalence Index ◽

Epidemiological Analysis ◽

Autonomous Region ◽

Drug Resistance Mutations ◽

Subtype B ◽

Primary Drug Resistance ◽

Epidemiological Characteristics ◽

Hiv 1

Objective: to perform a molecular-epidemiological analysis of HIV-1 variants circulating in the Jewish autonomous region territory. Materials and methods. The research included 58 patients with HIV-infection. Amplified pol-gene fragments were used as a template to detect drug resistance mutations by Sanger sequencing (AmpliSens® HIV-Resist-Seq). Pol-gene is coding protease and a part of reverse transcriptase of HIV-1. Phylogenetic analysis was performed using MEGA version 6.0 program. Results: the research revealed an insignificant prevalence of HIV-1 СRF63_02A1 recombinant form. It was registered in 25 patients (44,6%). Sub-subtype A6 was identified in 23 HIV-positive people (41,1%). Subtype B was revealed in 6 cases (10,7%), subtype С — in two cases (3,6%). Primary drug resistance mutations were identified in 9 patients that were undergoing antiretroviral treatment. This dictates the necessity to change the treatment regimen in the specified patients. The prevalence index of drug resistance mutations in naïve patients equaled to 3,8%.

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Transmitted drug resistance mutations and subtype diversity amongst HIV-1 sero-positive voluntary blood donors in Accra, Ghana

10.21203/rs.3.rs-21810/v2 ◽

2020 ◽

Author(s):

Billal Musah Obeng ◽

Evelyn Yayra Bonney ◽

Lucy Asamoah-Akuoko ◽

Nicholas Israel Nii-Trebi ◽

Gifty Mawuli ◽

...

Keyword(s):

Drug Resistance ◽

Blood Donors ◽

Transmitted Drug Resistance ◽

Nucleotide Sequencing ◽

Plasma Samples ◽

Resistance Mutations ◽

Drug Resistance Mutations ◽

Subtype B ◽

Major Drug ◽

Hiv 1

Abstract Background: Detection of HIV-1 transmitted drug resistance (TDR) and subtype diversity (SD) are public health strategies to assess current HIV-1 regimen and ensure effective therapeutic outcomes of antiretroviral therapy (ART) among HIV-1 patients. Globally, limited data exist on TDR and SD among blood donors. In this study, drug resistance mutations (DRMs) and SD amongst HIV-1 sero-positive blood donors in Accra, Ghana were characterized.Methods: Purposive sampling method was used to collect 81 HIV sero-positive blood samples from the Southern Area Blood Center and confirmed by INNO-LIA as HIV-1 and/or HIV-2. Viral RNA was only extracted from plasma samples confirmed as HIV-1 positive. Complementary DNA (cDNA) was synthesized using the RNA as a template and subsequently amplified by nested PCR with specific primers. The expected products were verified, purified and sequenced. Neighbour-joining tree with the Kimura’s 2-parameter distances was generated with the RT sequences using Molecular Evolutionary Genetic Analysis version 6.0 (MEGA 6.0).Results: Out of the 81 plasma samples, 60 (74%) were confirmed as HIV-1 sero-positive by INNO-LIA HIVI/II Score kit with no HIV-2 and dual HIV-1/2 infections. The remaining samples, 21 (26%) were confirmed as HIV sero-negative. Of the 60 confirmed positive samples, (32) 53% and (28) 47% were successfully amplified in the RT and PR genes respectively. Nucleotide sequencing of amplified samples revealed the presence of major drug resistance mutations in two (2) samples; E138A in one sample and another with K65R. HIV-1 Subtypes including subtypes A, B, CRF02_AG and CRF09_cpx were found. Conclusion: This study found major drug resistance mutations, E138A and K65R in the RT gene that confer high level resistance to most NNRTIs and NRTI respectively. CRF02_AG was most predominant, the recorded percentage of subtype B and the evolutionary relationship inferred by phylogenetic analysis may suggest possible subtype importation. However, a more prospective and detailed analysis is needed to establish this phenomenon. The data obtained would inform the selection of drugs for ART initiation to maximize therapeutic options in drug-naïve HIV-1 patients in Ghana.

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Analysis of HIV-1 pol sequences from Panama: Identification of phylogenetic clusters within subtype B and detection of antiretroviral drug resistance mutations☆

Infection Genetics and Evolution ◽

10.1016/j.meegid.2009.06.013 ◽

2009 ◽

Vol 9 (5) ◽

pp. 933-940 ◽

Cited By ~ 20

Author(s):

Sara Ahumada-Ruiz ◽

Dario Flores-Figueroa ◽

Iván Toala-González ◽

Michael M. Thomson

Keyword(s):

Drug Resistance ◽

Resistance Mutations ◽

Antiretroviral Drug Resistance ◽

Drug Resistance Mutations ◽

Subtype B ◽

Antiretroviral Drug ◽

Hiv 1

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Simultaneous Detection of Major Drug Resistance Mutations of HIV-1 Subtype B Viruses from Dried Blood Spot Specimens by Multiplex Allele-Specific Assay: TABLE 1

Journal of Clinical Microbiology ◽

10.1128/jcm.02833-15 ◽

2015 ◽

Vol 54 (1) ◽

pp. 220-222 ◽

Cited By ~ 8

Author(s):

Guoqing Zhang ◽

Fangping Cai ◽

Ivette Lorenzana de Rivera ◽

Zhiyong Zhou ◽

Jing Zhang ◽

...

Keyword(s):

Drug Resistance ◽

Simultaneous Detection ◽

Dried Blood Spots ◽

Resistance Mutations ◽

Subtype C ◽

Drug Resistance Mutations ◽

Subtype B ◽

Allele Specific ◽

Major Drug ◽

Hiv 1

A multiplex allele-specific (MAS) assay has been developed for the detection of HIV-1 subtype C drug resistance mutations (DRMs). We have optimized the MAS assay to determine subtype B DRMs in dried blood spots (DBS) collected from patients on antiretroviral therapy. The new assay accurately detected DRMs, including low-abundance mutations that were often missed by Sanger sequencing.

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A2 Phylogenetic investigation of transmitted HIV-1 drug resistance mutations in Denmark, 2009–17

Virus Evolution ◽

10.1093/ve/vez002.001 ◽

2019 ◽

Vol 5 (Supplement_1) ◽

Author(s):

J Fonager ◽

T K Fischer

Keyword(s):

Drug Resistance ◽

Resistance Testing ◽

Transmitted Drug Resistance ◽

Newly Diagnosed ◽

Resistance Mutations ◽

Sequence Alignments ◽

Drug Resistance Mutations ◽

Subtype B ◽

Genotypic Resistance Testing ◽

Hiv 1

Abstract Transmission of HIV-1 resistance mutations among therapy-naïve patients impairs the efficiency of antiretroviral therapy (ART). Therefore, genotypic resistance testing of patients is recommended at baseline, as this both allows for the selection of the correct ART regimen and for surveillance of transmitted drug resistance mutations (TDRM) among therapy naive HIV-1 patients. In Denmark, the occurrence of TDRM in newly diagnosed and therapy naïve HIV-1 patients is monitored through the SERO project. Here, we investigated if the prevalence of TDRM differed between patients within and outside of phylogenetically identified transmission clusters. Samples from 1,227 newly diagnosed HIV-1 patients were sent along with epidemiological information to the Virological Surveillance and Research group at Statens Serum Institut. HIV-1 RNA extraction, RT-PCR and Sanger sequencing of the pol gene was performed using an in-house assay. The sequences were analyzed using BioNumerics v. 6.6 and manually checked for the presence of mixed mutations and analyzed for mutations using the HIVDB 8.4 algorithm implemented at the Stanford database. Sequence alignments were performed in Mafft, and phylogenetic analysis was performed using Mega 6.0 using the Maximum likelihood general time reversible model with 100 bootstrap replicates. Clusters were identified with ClusterPicker at default settings (cluster support = 90%, genetic distance 4.5%). Active clusters contained newly diagnosed patients from the 2015 to 2017 period. HIV-1 sequences from 588 patients belonged to one of 154 clusters, and sequences from 639 patients did not belong to a cluster. Patients in clusters were significantly more likely to be men who have sex with men and subtype B and significantly less likely to be late presenters (Fisher’s test P < 0.05). The TDRM prevalence was significantly higher for patients outside of clusters than within clusters, 16.6 per cent versus 12.1 per cent, respectively (Fisher’s test P < 0.05); however, no significant differences were found in the TDRM prevalence between the 75 active and 79 inactive clusters, nor between small (<3 patients) and large (≥3 patients) clusters. E138A, V179D, and K103N were the three most prevalent TDRMs for both patient groups, whereas M41L differed between them. In Denmark, the TDRM prevalence is lower within clusters than outside, indicating that TDRM cases are either imported and/or belong to yet unidentified clusters.

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