Analysis of Protease and Reverse Transcriptase Genes of HIV for Antiretroviral Drug Resistance in Jamaican Adults

Abstract

This study reports on the drug resistance profiles for HIV-infected adults in Jamaica using genotypic methods. The genetic diversity of HIV-1 found in these patients was also determined using phylogenetic analysis. Epidemiological data were documented for each patient, blood was collected by venous puncture, and plasma was separated and stored. Viral RNA was extracted and analyzed for mutations in the viral genome by the amplification of the protease and reverse transcriptase (Pro-RT) regions using a nested PCR method. The rate of drug resistance among treatment-experienced individuals was 35%, while treatment-naive individuals showed a prevalence of 29%. The overall prevalence of drug resistance mutations in Jamaicans was consistent with the increased use of antiretroviral drugs in the region, with many of the mutations detected reducing susceptibility to the drugs commonly used to treat Jamaican patients. These results indicate the need for regular drug resistant surveillance to guide treatment strategies.

HIV-1 Antiretroviral Drug Resistance in Pregnant Women in Jamaica: A Preliminary Report

“…However, it has been shown that ART used in the presence of drug-resistant viruses may increase the risk of HIV-1 mutagenesis which can compromise the efficacy of ARV therapy (18). With the scaling-up of the treatment programmes in Jamaica, the emergence of HIVDR becomes increasingly more apparent (19). Thus, baseline testing should be seen as standard part of treatment.…”

Spatiotemporal Dynamics of Dissemination of Non-Pandemic HIV-1 Subtype B Clades in the Caribbean Region

“…The subtype B dominates the HIV-1 epidemic in most Caribbean islands [7], [8], [9], [10], [11], [12], [13], [14], with exception of Cuba where several non-B genetic forms are collectively more prevalent [15], [16], [17], [18], [19], [20]. Genetic evidence suggests that the HIV-1 subtype B was introduced from Central Africa into America through Haiti around the middle 1960s, coinciding with the return of many Haitian professionals who worked in the Democratic Republic of Congo [21].…”

HIV Drug Resistance Surveillance Among Jamaican Men Who Have Sex with Men Should Be Prioritized for Reducing HIV Transmission

“…13 None of the samples had major protease inhibitor mutations, in contrast to findings among a Jamaican heterosexual cohort. 7 The epidemiology survey through which these samples were obtained did not ask respondents to self-report whether they previously received ARV treatment; it is therefore unclear whether the 26% prevalence of drug resistance is acquired, transmitted, or due to both. The M184V mutation readily emerges during suboptimal lamivudine treatment, but reduces the ability of the virus to replicate.…”

“…4 However, scaling up of antiretroviral use necessitates increased surveillance of HIV drug resistance. 4,5 A transmitted drug resistance of 12-29% has been reported for HIV-infected heterosexuals in Jamaica, 6,7 but estimates of drug resistance among the island's MSM is lacking. Integrating the use of ARV drugs in HIV prevention programs for Jamaica's MSM should be considered since HIV prevalence among this risk group has remained high since 1995, despite HIV educational interventions for behavior change.…”