Sex Transm Infect 88:179-183 doi:10.1136/sextrans-2011-050209
  • Clinical
  • Original article

Transmission of HIV-1 drug resistance in Benin could jeopardise future treatment options

  1. Cécile Tremblay1,5
  1. 1Centre de Recherche du Centre Hospitalier de l'Université de Montréal (CRCHUM), Montréal, Quebec, Canada
  2. 2Dispensaire IST, Centre de santé de Cotonou I, Cotonou, Bénin
  3. 3Centre de traitement ambulatoire du Centre national hospitalier universitaire, Cotonou, Bénin
  4. 4Centre de recherche de l'Hôpital Maisonneuve-Rosemont, Montréal, Quebec, Canada
  5. 5Département de microbiologie et immunologie, Université de Montréal, Montréal, Quebec, Canada
  6. 6Department of Ecology and Evolutionary Biology, University of Arizona, Tucson, Arizona, USA
  7. 7URESP, Centre de recherche FRSQ du CHA universitaire de Québec, Québec, Canada
  8. 8Département de médecine sociale et préventive, Université Laval, Québec, Canada
  9. 9Institut national de santé publique du Québec, Québec, Canada
  1. Correspondence to Dr Cécile Tremblay, Centre Hospitalier de l'Université de Montréal, 3840, rue St-Urbain, Bureau 7-355, Montréal, QC, Canada H2W 1T8; c.tremblay{at}
  1. Contributors AC was in charge of most of the experiments in this study, analysis of the data and in writing this article. SD was in charge of supervising the study in Cotonou, Benin. MS performed some of the experiments for this paper. SA is in charge of co-supervising the clinical work at the sex worker clinics. NG was the MD in charge of sex worker clinic in Cotonou. DMZ is co-supervising the clinical work at the Centre National Hospitalier Universitaire de Cotonou and he also seen patients enrolled in the study. A-CL was in charge of co-supervising the diagnostic laboratory tests. MW performed the phylogenetic analysis. MA is in charge of the behavioural aspects of the study and participated in the preparation of the manuscript. CT is the principal investigator of this study and participated in the preparation of the manuscript.

  • Accepted 6 November 2011
  • Published Online First 12 December 2011


Objectives As access to antiretrovirals (ARV) increases in developing countries, the identification of optimal therapeutic regimens and prevention strategies requires the identification of resistance pathways in non-B subtypes as well as the surveillance of drug mutation resistance (SDMR) including the trafficking of viral strains between high-risk groups such as commercial sex workers (CSW) and the general population (GP). In this study, the authors evaluated the rate of primary resistance mutations and the epidemiological link between isolates from GP and CSW from Bénin.

Methods Plasma samples were obtained from 129 HIV-1-infected treatment-naïve individuals. Drug resistance mutations were identified using SDMR list and compared with other resistance algorithms.

Results No nucleoside reverse transcriptase inhibitor resistance mutations were found. Four patients had non-nucleoside reverse transcriptase inhibitor resistance (K103N, G190A). One patient exhibited protease inhibitors resistance mutation, F53Y. Using the SDMR list, the authors obtained a rate of 3.9% of primary resistance. Nevertheless, the authors observed several mutations not on SDMR list but included in others resistance database, taking those mutations into account, the authors obtained a rate of 15.5%.

Conclusions Although our results show a low rate of SDMR, this algorithm may underestimate resistance mutations that may impact treatment options in developing countries. Primary resistance rates were similar in CSW and in the GP. Our phylogenetic analysis confirmed the genetic exchange between groups.


  • Funding This scientific work was supported financially by a research grant from the Canadian Institutes of Health Research (CIHR) HPR-85528, by Fonds de la recherche en santé du Québec (FRSQ) and by Virco BVBA. MA was a national researcher of the Fonds de la recherche en santé du Québec, grant #8722. CT is the University of Montreal/Pfizer Chair on translational HIV research.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval CRCHUM, Ethics Institutional Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.