Phylogenetic analysis of HIV-1 subtypes and drug resistance profile among treatment-naïve people in Kuwait

Chehadeh, Wassim; Albaksami, Osama; Altawalah, Haya; Ahmad, Suhail; Madi, Nada; John, Sonia Elezebeth; Abraham, Priya; Al‐Nakib, W.

doi:10.1002/jmv.24212

Cited by 9 publications

(8 citation statements)

References 22 publications

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“…In this study, the HIV-1 subtypes CRF01_AE, C, and B were found to be the most prevalent subtypes detected in Kuwait, consistent with previous observations [6] and the findings reported in the Gulf region about the circulation of pure subtypes A, B, and C and of recombinant forms like CRF35_AD [21,22]. Of interest, around 10% of the patients had the HIV-1 subtype CRF02_AG that is prevalent in West Africa and Russia with a global prevalence of ∼5% [23].…”

Section: Discussionsupporting

confidence: 92%

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Drug Resistance-Associated Mutations in Antiretroviral Treatment-Experienced Patients in Kuwait

et al. 2018

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Objectives: To investigate the prevalence of nonpolymorphic resistance-associated mutations (RAM) in HIV-1 patients on first-line antiretroviral therapy in Kuwait. Subjects and Methods: Total RNA was isolated from plasma samples of 42 patients who received a first-line nonnucleoside reverse transcriptase inhibitor (NNRTI)-based regimen. HIV-1 protease and reverse transcriptase genetic regions were then amplified by nested reverse transcription-polymerase chain reaction and directly sequenced. The HIV-1 subtype was identified using the Bayesian phylogenetic method, and RAM were identified using the Stanford University genotypic resistance interpretation algorithm. Results: The HIV-1 viral load at sampling ranged from < 20 to 8.25 × 10⁴ copies/ml. CRF01_AE, C, and B were the most predominant HIV-1 subtypes. Nonpolymorphic mutations associated with resistance to antiretroviral drugs were detected in 11 (26.2%) of the 42 patients; 5 (11.9%) patients had mutations associated with a high-level resistance to nucleoside reverse transcriptase inhibitors (NRTI), 4 (9.5%) patients had mutations associated with resistance to NNRTI, 1 (2.4%) patient had mutations associated with resistance to both NRTI and NNRTI, and 1 (2.4%) patient had mutations potentially associated with low-level resistance to both protease inhibitors and NNRTI. All patients with RAM had a detectable plasma HIV-1 RNA level. Conclusion: Our results indicate the development of RAM during an NNRTI-based regimen and highlight the importance of considering other regimens to avoid treatment failure.

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Section: Discussionsupporting

confidence: 92%

“…In a pilot study [6] conducted on 28 treatment-naive Kuwaiti patients, a total of 10 different subtypes and recombinant forms were detected, with a predominance of subtypes B, C, and CRF01_AE. Moreover, 2 RAM were detected, one of which was associated with low-to intermediate-level resistance to NNRT.…”

Section: Introductionmentioning

confidence: 99%

Drug Resistance-Associated Mutations in Antiretroviral Treatment-Experienced Patients in Kuwait

et al. 2018

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“…Many people are likely to be in early stages of HIV but, HIV-related behaviors in Arab states are issues with poor cultural acceptance among people, as well as insufficient responses in public health sectors (20, 25-27). As a result, HIV data are not documented.…”

Section: Discussionmentioning

confidence: 99%

HIV Responses in Arab States on the Southern Persian Gulf Border: The First Review

Moradi

Alammehrjerdi

Daneshmand

et al. 2016

Iran J Psychiatry Behav Sci

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ContextThere is no review of HIV responses in Arab states on the southern Persian Gulf border. This narrative review aimed to describe and synthesize HIV responses in Kuwait, Qatar, Bahrain and the United Arab Emirates (UAE).Evidence AcquisitionA review of scientific databases and grey literature was conducted based on an international guide. Overall, 16 original studies and reports were found.ResultsThe review indicates that HIV has been found present in each Arab state based on sporadic case finding. The prevalence of HIV is the result of heterosexual relationship and/or drug injection. Mandatory testing of the nationals and expatriate workers is the main route of HIV detection. In general, HIV knowledge and education are poor. Only Bahrain has some non-governmental organizations that provide HIV education. Lack of identifying key populations and high risk behaviors has been reported in all of the states. HIV responses are mainly for Arab and Arabic-speaking nationals. Effective strategic plans for HIV have not been developed in all of the states. The provision of antiretroviral therapy for the nationals is the main HIV response. Only Qatar has paid for the treatment of Qatari and non-Qatari HIV-infected patients. As a HIV response, drug treatment is based on short-term inpatient rehabilitation. Only Qatar has voluntary HIV counseling and testing. Lack of needle and syringe programs has been reported for people who inject drugs with HIV problem in all of the states.ConclusionsTo conclude, HIV problem needs a comprehensive policy response in each state. Providing effective strategic plans for HIV and sero-surveillance data systems is required. Empowering human resources and infrastructural development are suggested.

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“…In the State of Kuwait, 30-50 new HIV-1 cases are reported annually [9] with a prevalence of non-B subtypes, which constitute more than 75% of the reported subtypes [10]. NNRTI-, PI-, and INSTI-based regimens are all available in Kuwait.…”

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confidence: 99%

“…NNRTI-, PI-, and INSTI-based regimens are all available in Kuwait. Mutations associated with low-to intermediate-level resistance to NNRTs have been detected in treatment-naïve patients [10]. Previous studies have found differences in the resistance profiles of different subtypes to INSTIs [11,12].…”

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confidence: 99%

Resistance-Associated Mutations and Polymorphisms among Integrase Inhibitor-Naïve HIV-1 Patients in Kuwait

Chehadeh¹,

Albaksami²,

John³

et al. 2017

Intervirology

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Objectives: Resistance-associated mutations (RAMs) in the integrase of different HIV-1 subtypes were investigated in a cohort of patients never exposed to integrase strand transfer inhibitors (INSTIs). Methods: The viral RNA was extracted from plasma samples of 53 INSTI-naïve patients, and the integrase genetic region was sequenced and analyzed for subtype assignment and drug resistance. Results: The median viral load at sampling was 5.28 × 10⁴ RNA copies/mL. Bayesian phylogenetic analysis showed 85% of the HIV-1 isolates were non-B subtypes, with a predominance of subtypes C (22.6%) and CRF01_AE (26.4%). A total of 52 and 110 mutations were found in the integrase region of HIV-1 B and non-B subtypes, respectively. Nonpolymorphic INSTI-RAMs were not detected in this study. However, the accessory mutation E157Q was found in 1 patient with CRF02_AG, and the polymorphic mutations L74M/I that may contribute to a reduced susceptibility to INSTIs in the presence of major mutations were observed in 6 (13.3%) patients with non-B subtypes and 1 (12.5%) patient with the B subtype. Polymorphic mutations at positions known to harbor primary and accessory RAMs were also detected in this study. Conclusion: Our results highlight the importance of monitoring the emergence of INSTI-RAMS before and after the initiation of INSTI-based therapy.

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Phylogenetic analysis of HIV-1 subtypes and drug resistance profile among treatment-naïve people in Kuwait

Cited by 9 publications

References 22 publications

Drug Resistance-Associated Mutations in Antiretroviral Treatment-Experienced Patients in Kuwait

Drug Resistance-Associated Mutations in Antiretroviral Treatment-Experienced Patients in Kuwait

HIV Responses in Arab States on the Southern Persian Gulf Border: The First Review

Resistance-Associated Mutations and Polymorphisms among Integrase Inhibitor-Naïve HIV-1 Patients in Kuwait

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