1
HIV Pathogenesis Programme, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Private Bag X7, Congella, Durban 4013, South Africa
2
Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Private Bag X7, Congella, Durban 4013, South Africa
3
Rega Institute for Medical Research, Department of Microbiology and Immunology, KU Leuven–University of Leuven, 3000 Leuven, Belgium
4
Artificial Intelligence Lab, Department of Computer Science, Vrije Universiteit Brussel, Brussels, 1050 Elsene, Belgium
5
Division of Infectious Disease, Emory University School of Medicine, Atlanta, GA 30322, USA
6
Infectious Diseases Unit, Nelson Mandela School of Medicine, University of KwaZulu-Natal, Private Bag X7, Congella, Durban 4013, South Africa
7
Africa Health Research Institute, University of KwaZulu-Natal, Private Bag X7, Congella, Durban 4013, South Africa
8
Ragon Institute of MGH, MIT and Harvard University, Cambridge, MA 01239, USA
9
Max Planck Institute for Infection Biology, Chariteplatz, D-10117 Berlin, Germany
†
These authors contributed equally to this work.
Abstract
The South African national treatment programme includes nucleoside reverse transcriptase inhibitors (NRTIs) in both first and second line highly active antiretroviral therapy regimens. Mutations in the RNase H domain have been associated with resistance to NRTIs but primarily in HIV-1 subtype B studies.
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The South African national treatment programme includes nucleoside reverse transcriptase inhibitors (NRTIs) in both first and second line highly active antiretroviral therapy regimens. Mutations in the RNase H domain have been associated with resistance to NRTIs but primarily in HIV-1 subtype B studies. Here, we investigated the prevalence and association of RNase H mutations with NRTI resistance in sequences from HIV-1 subtype C infected individuals. RNase H sequences from 112 NRTI treated but virologically failing individuals and 28 antiretroviral therapy (ART)-naive individuals were generated and analysed. In addition, sequences from 359 subtype C ART-naive sequences were downloaded from Los Alamos database to give a total of 387 sequences from ART-naive individuals for the analysis. Fisher’s exact test was used to identify mutations and Bayesian network learning was applied to identify novel NRTI resistance mutation pathways in RNase H domain. The mutations A435L, S468A, T470S, L484I, A508S, Q509L, L517I, Q524E and E529D were more prevalent in sequences from treatment-experienced compared to antiretroviral treatment naive individuals, however, only the E529D mutation remained significant after correction for multiple comparison. Our findings suggest a potential interaction between E529D and NRTI-treatment; however, site-directed mutagenesis is needed to understand the impact of this RNase H mutation.
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