{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T22:51:40Z","timestamp":1779144700581,"version":"3.51.4"},"reference-count":49,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2009,12,1]],"date-time":"2009-12-01T00:00:00Z","timestamp":1259625600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AIDS Research and Human Retroviruses"],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:p>\n                    The treatment of HIV-1 infection with antiretroviral drugs has greatly improved the survival of those who are infected. However, HIV-1 diversity and drug resistance are major challenges in patient management, especially in resource-poor countries. To evaluate HIV-1 genetic diversity and drug resistance-associated mutations among drug-naive patients in Kenya prior to antiretroviral therapy (ART), a genetic analysis of HIV-1\n                    <jats:italic toggle=\"yes\">pol<\/jats:italic>\n                    -RT and\n                    <jats:italic toggle=\"yes\">env-gp41<\/jats:italic>\n                    was performed on samples collected from 53 (18 males and 35 females) consenting patients between April and June 2005. The average age, baseline CD4\n                    <jats:sup>+<\/jats:sup>\n                    T cell counts, and viral loads were 38 (range, 24\u201362) years, 475 (range, 203\u2013799) cells\/mm\n                    <jats:sup>3<\/jats:sup>\n                    , and 4.7 (range, 3.4\u20135.9) log\n                    <jats:sub>10<\/jats:sub>\n                    copies\/ml, respectively. Phylogenetic analysis revealed that 40 samples (75.5%) were concordant subtypes for the two genes and 13 (24.5%) were discordant, suggesting possible recombination and\/or dual infections. Prevalent subtypes included A1\/A1(\n                    <jats:italic toggle=\"yes\">pol<\/jats:italic>\n                    -RT\/\n                    <jats:italic toggle=\"yes\">env<\/jats:italic>\n                    -\n                    <jats:italic toggle=\"yes\">gp41<\/jats:italic>\n                    ), 31 (58.5%); D\/D, 9 (16.9%); A1\/C, 2 (3.8%); A1\/D, 4 (7.5%); G\/A1, 2 (3.8%); A1\/A2, 1 (1.9%); C\/A1, 2 (3.8%); D\/A1, 1(1.9%); and D\/A2, 1 (1.9%). Major reverse transcriptase inhibitor (RTI) resistance-associated mutations were found in four patients (7.5%). Of these patients, three had nucleoside RTI resistance mutations, such as M184V, K65R, D67N, K70R, and K219Q. Nonnucleoside RTI resistance-associated mutations K103N and Y181C were detected in three patients and one patient, respectively. Multiple drug resistance mutations were observed in this drug-naive population. With increasing numbers of patients that require treatment and the rapid upscaling of ART in Kenya, HIV-1 drug resistance testing is recommended before starting treatment in order to achieve better clinical outcomes.\n                  <\/jats:p>","DOI":"10.1089\/aid.2009.0007","type":"journal-article","created":{"date-parts":[[2009,12,2]],"date-time":"2009-12-02T09:55:37Z","timestamp":1259747737000},"page":"1211-1217","source":"Crossref","is-referenced-by-count":21,"title":["HIV Type 1 Subtype Diversity and Drug Resistance among HIV Type 1-Infected Kenyan Patients Initiating Antiretroviral Therapy"],"prefix":"10.1177","volume":"25","author":[{"given":"Raphael W.","family":"Lihana","sequence":"first","affiliation":[{"name":"Kenya Medical Research Institute","place":["Kenya"]},{"name":"Kanazawa University","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samoel A.","family":"Khamadi","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute","place":["Kenya"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kizito","family":"Lubano","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute","place":["Kenya"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raphael","family":"Lwembe","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute","place":["Kenya"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael K.","family":"Kiptoo","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute","place":["Kenya"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy","family":"Lagat","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute","place":["Kenya"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joyceline G.","family":"Kinyua","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute","place":["Kenya"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fredrick A.","family":"Okoth","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute","place":["Kenya"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elijah M.","family":"Songok","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute","place":["Kenya"]},{"name":"University of Manitoba","place":["Canada"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ernest P.","family":"Makokha","sequence":"additional","affiliation":[{"name":"Kenya Medical Research Institute","place":["Kenya"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Ichimura","sequence":"additional","affiliation":[{"name":"Kanazawa University","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2009,12,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1126\/science.2460924"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1128\/JVI.72.5.4224-4230.1998"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1038\/nm941"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1038\/nri1058"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkg079"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2004.01.010"},{"issue":"3","key":"e_1_3_3_8_2","first-page":"S31","article-title":"Understanding the genetic diversity of HIV-1","volume":"14","author":"McCutchan FE","year":"2000","unstructured":"McCutchan FE. Understanding the genetic diversity of HIV-1. AIDS, 2000; 14,Suppl 3:S31\u201344.","journal-title":"AIDS"},{"issue":"3","key":"e_1_3_3_9_2","first-page":"S129","article-title":"Genetic diversity of HIV-1: The moving target","volume":"14","author":"Peeters M","year":"2000","unstructured":"Peeters M, , Sharp PM. Genetic diversity of HIV-1: The moving target. AIDS, 2000; 14,Suppl 3:S129\u2013S140.","journal-title":"AIDS"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1089\/088922200309197"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000186361.42834.61"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2007.0212"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1293.2005.00326.x"},{"key":"e_1_3_3_14_2","unstructured":"Joint United Nations Programme on HIV\/AIDS\/World Health Organization. Treating 3 Million by 2005: Making It Happen\u2014The WHO Strategy. 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