Abstract:
Raltegravir, an integrase inhibitor, is not a component of the current South
African antiretroviral treatment guidelines, but it could be introduced in the near future as
cases of virological failures from current treatment regimens begin to occur. The aim of
this study was to analyze the complete HIV integrase gene obtained from individuals at
two treatment sites in northeastern South Africa for the presence of Raltegravir associated
drug resistant mutations and viral subtypes based on the integrase gene. Examination for
mutations against other integrase inhibitors, such as Elvitegravir and Dolutegravir, was
also done. Viruses from 127 treatment naive individuals were analyzed. Genetic drug
resistance mutations were determined using the Stanford HIV Drug Resistance Interpretation
program and the International AIDS society-USA guidelines. Viral subtyping was done by
phylogenetic analysis, and recombinants were determined using the REGA, jpHMM and
RIP tools. No major resistance mutations were detected. However, 7% of the sequences
had minor mutations and polymorphisms. The majority (99%) of the viruses were HIV-1
C. Recombination analysis showed that the polymerase gene of one virus was likely
composed of HIV-1 subtype A1 and C sequences. The present study indicates that
Raltegravir, Elvitegravir and Dolutegravir resistant mutations may be absent in the study
communities and further indicates the presence of recombinant viruses in northeastern
South Africa.
Description:
Publication of this article was funded by HIV/AIDS & Global Health Research Programme, University of Venda, Department of Microbiology
