The evolution of HIV-1 group M genetic variability in Southern Cameroon is characterized by several emerging recombinant forms of CRF02_AG and viruses with drug resistance mutations

• Published in: Journal of medical virology Vol. 86; no. 3; pp. 385 - 393
• Main Authors: Agyingi, Lucy, Mayr, Luzia M., Kinge, Thompson, Orock, George Enow, Ngai, Johnson, Asaah, Bladine, Mpoame, Mbida, Hewlett, Indira, Nyambi, Phillipe
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.03.2014; Wiley Subscription Services, Inc
• Subjects: Adolescent; Adult; Aged; Antiretroviral drugs; Cameroon; Cameroon - epidemiology; Drug resistance; drug resistance mutations; Drug Resistance, Viral; Epidemiology; Evolution, Molecular; Female; Genetic diversity; Genetic Variation; Genotype; HIV; HIV Infections - epidemiology; HIV Infections - virology; HIV-1 - classification; HIV-1 - genetics; HIV-1 - isolation & purification; Human immunodeficiency virus; Human immunodeficiency virus 1; Human Immunodeficiency Virus Proteins - genetics; Humans; Male; Middle Aged; Molecular Sequence Data; Mutation; Polymerase Chain Reaction; Recombination, Genetic; RNA, Viral - genetics; Sequence Analysis, DNA; unique recombinant forms; Virology; Young Adult; Cameroon; Cameroon, Limbe; genetic diversity; Cameroon; unique recombinant forms; drug resistance mutations
• ISSN: 0146-6615; 1096-9071; 1096-9071
• DOI: 10.1002/jmv.23846

The HIV epidemic in Cameroon is marked by a broad genetic diversity dominated by circulating recombinant forms (CRFs). Studies performed more than a decade ago in urban settings of Southern Cameroon revealed a dominance of the CRF02_AG and clade A variants in >90% of the infected subjects; however, little is known about the evolving viral variants circulating in this region. To document circulating HIV viral diversity, four regions of the viral genome (gag, PR, reverse transcriptase, env) in 116 HIV‐1 positive individuals in Limbe, Southern Cameroon, were PCR‐amplified. Sequences obtained at the RT and protease regions were analyzed for mutations that conferred drug resistance using the Stanford Drug Resistance Database. The present study reveals a broad genetic diversity characterized by several unique recombinant forms (URF) accounting for 36% of infections, 48.6% of patients infected with CRF02_AG, and the emergence of CRF22_01A1 in 7.2% of patients. Three out of 15 (20%) treated patients and 13 out of 93 (13.9%) drug naïve patients harbor drug resistance mutations to RT inhibitors, while 3.2% of drug naïve patients harbor drug resistance mutations associated with protease inhibitors. The high proportion (13.9%) of drug resistance mutations among the drug naïve patients reveals the ongoing transmission of these viruses in this region of Cameroon and highlights the need for drug resistance testing before starting treatment for patients infected with HIV‐1. J. Med. Virol. 86:385–393, 2014. © 2013 The Authors. Journal of Medical Virology Published by Wiley Periodicals, Inc.