Introduction The Human Immunodeficiency virus (HIV) epidemic is characterised by the dominance of HIV type 1 (HIV-1) worldwide. Consequently, antiretroviral therapy (ART) and drug resistance studies have focused almost exclusively on HIV-1. In Ghana both HIV-1 and HIV-2 co-circulate with lack of data on HIV-2 drug resistance mutations. We sought to determine drug resistance mutations in HIV-2 patients in Ghana.

Method We used purposive sampling to collect blood from 16 consented patients confirmed as HIV-2 and dual HIV-1/2 by serology and molecular assays. Real-time RT-PCR assay was used to determine the viral load of patients by using an HIV-2 RNA International Standard from the National Institute for Biological Standards and Control (NIBSC). Nucleic acid (RNA and DNA) were extracted from plasma and peripheral blood mononuclear cells (PBMC) respectively. The reverse transcriptase (RT) and protease (PR) genes of HIV-2 were amplified by PCR, sequenced and analysed for drug resistance mutations and subtype information.

Results HIV-2 RNA was detected in 7 of 10 ART-naïve and 2 of 6 ART-experienced patients. Detectable HIV-2 viral loads in these patients ranged from below the lower limit of quantification (<2.35 log IU/ml) to 5.45 log IU/ml. One ART-experienced patient had M184V, K65R and Y115F mutations in RT sequences from both plasma and PBMC. There were no drug resistance mutations identified from ART- naïve samples.

Conclusion This is the first study in Ghana to show evidence of mutations in HIV-2 strains from patients receiving HIV-1 targeted antiretrovirals. The results prompt monitoring of drug resistance to improve clinical management of HIV-2 infected patients.