HIV type 1 pol gene diversity and archived nevirapine resistance mutation in pregnant women in Rwanda.

This study aimed to find out whether genetic polymorphisms were present in positions potentially affecting susceptibility to antiretrovirals in non-B subtypesfrom HIV-1-infected patients in Rwanda. Viral pol gene diversity was investigated by direct sequencing in 43 treatment-naive women. In addition, 10 DNA sequences from uncultured peripheral blood mononuclear cells were analyzed 6 weeks after a single dose of nevirapine(prevention of mother-to-child transmission program). Phylogenetic analyses have shown 34 subtypeA1, 6 subtypeC, and 2 subtypeD strains. In addition, an A/C recombinant between the protease (PR) ( subtypeA1) and the reverse transcriptase (RT) ( subtypeC) was identified. In the PR coding region, high numbers of polymorphisms were found, including substitutions in secondary PR resistance sites. PR 35D, 36I, and 37N were always present within subtypeA as were PR 93L in subtypeC strains. PR 10I/V, 20R, 33F, and 77V were found in subtypeA whereas PR 36I was highly prevalent in subtype...