Drug resistance mutations and genetic diversity in adults treated for HIV type 1 infection in Mauritania

The aim of this cross‐sectional study was to evaluate the drug resistance mutationprofile observed in patients receiving antiretroviral therapy with virological failure and to document the HIV‐1 genetic diversity in Mauritania. Eighty‐six subjects were included and 65 samples were amplified successfully and sequenced. HIV‐1 genotyping was performed using the Agence Nationale de Recherche sur le SIDA AC11 resistance procedure. The median treatment duration was 32 months (range: 6–88) and the median viral load, 5 log10 copies/ml (range: 3.13–7). Fifty‐nine patients (90.8%) were on first line regimens including 32.0% (19/59) on triomune fixed‐dose and six on second‐line therapy with NonNucleoside Reverse Transcriptase plus a protease inhibitor. Forty‐seven patients (72.3%) had at least one drug resistance mutation including 73.0% (43/59) on first‐line therapy. For the second‐line, one out of six patients presented resistance mutations and only one presented PI DRM. Overall, the most common DRMs detected were M184V/I (n = 32; 49.2%), K103N (n = 28; 43%), and Y181C (n = 13; 20%). Thymidine Analog Mutations (TAMs) were found in 26.0% (n = 17) of strains and the most common was T215Y (n = 11, 16.9%). Phylogenetic analysis revealed 17 HIV‐1 variants with the predominance of CRF02_AG (n = 42; 64.6%). A high rate of DRM was found in this study and shows the potential need for a structured virological surveillance including viral load quantification and genotyping. Further studies may also be needed in regards to the great variability of HIV‐1 strains in Mauritania. J. Med. Virol. 86:404–410, 2014. © 2013 Wiley Periodicals, Inc.