@article{fdi:010068326,
  title = {{I}n-depth analysis of {HIV}-1 drug resistance mutations in {HIV}-infected individuals failing first-line regimens in {W}est and {C}entral {A}frica},
  author = {{V}illabona-{A}renas, {C}. {J}. and {V}idal, {N}icole and {G}uichet, {E}milande and {S}errano, {L}. and {D}elaporte, {E}ric and {G}ascuel, {O}. and {P}eeters, {M}artine},
  editor = {},
  language = {{ENG}},
  abstract = {{O}bjective: {I}n resource-limited countries, antiretroviral therapy ({ART}) has been scaled up, but individual monitoring is still suboptimal. {H}ere, we studied whether or not {ART} had an impact on the frequency and selection of drug resistance mutations ({DRM}s) under these settings. {W}e also examined whether differences exist between {HIV}-1 genetic variants. {D}esign: {A} total of 3736 sequences from individuals failing standard first-line {ART} (n = 1599, zidovudine/stavudine + lamivudine + neviparine/efavirenz) were analyzed and compared with sequences from reverse transcriptase inhibitor ({RTI})-naive individuals (n = 2137) from 10 {W}est and {C}entral {A}frican countries. {M}ethods: {F}isher exact tests and corrections for multiple comparisons were used to assess the significance of associations. {R}esults: {A}ll {RTI}-{DRM} from the 2015 {I}nternational {A}ntiviral {S}ociety list, except {F}227{C}, and nine mutations from other expert lists were observed to confer extensive resistance and cross-resistance. {F}ive additional independently selected mutations ({I}94{L}, {L}109{I}, {V}111{L}, {T}139{R} and {T}165{L}) were statistically associated with treatment. {T}he proportion of sequences with multiple mutations and the frequency of all thymidine analog mutations, {M}184{V}, certain {NNRTIS}, {I}94{L} and {L}109{I} showed substantial increase with time on {ART}. {O}nly one nucleoside and two nonnucleoside {RTI}-{DRM}s differed by subtype/circulating recombinant form. {C}onclusion: {T}his study validates the global robustness of the actual {DRM} repertoire, in particular for circulating recombinant form 02 predominating in {W}est and {C}entral {A}frica, despite our finding of five additional selected mutations. {H}owever, long-term {ART} without virological monitoring clearly leads to the accumulation of mutations and the emergence of additional variations, which limit drug options for treatment and can be transmitted. {I}mproved monitoring and optimization of {ART} are necessary for the long-term effectiveness of {ART}.},
  keywords = {antiretroviral therapy ; drug resistance ; {HIV}-1 ; mutation ; sub-{S}aharan {A}frica ; treatment failure ; {AFRIQUE} {SUBSAHARIENNE} ; {BURUNDI} ; {CAMEROUN} ; {TCHAD} ; {REPUBLIQUE} {DEMOCRATIQUE} {DU} {CONGO} ; {GUINEE} {EQUATORIALE} ; {BENIN} ; {BURKINA} {FASO} ; {COTE} {D}'{IVOIRE} ; {SENEGAL} ; {TOGO}},
  booktitle = {},
  journal = {{A}ids},
  volume = {30},
  numero = {17},
  pages = {2577--2589},
  ISSN = {0269-9370},
  year = {2016},
  DOI = {10.1097/qad.0000000000001233},
  URL = {https://www.documentation.ird.fr/hor/fdi:010068326},
}