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Associate Professor
Yaya Kassogue

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Dr Moses Egesa

Dr Mercy Karoney

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Dr Moses Egesa

Dr Aida Sivro

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Project Title

Study of Pharmacogenetics of ARVs treatment outcomes in Mali, West Africa

EDCTP Project

TMA2016CDF1566

EDCTP Program

EDCTP2

EDCTP Project Call

Career Development Fellowship (CDF)

Project Objectives

Main objective : To study the genetic factors that influence the response to ARV treatment in patients living with HIV. Secondary objectives - To establish the genotypic frequencies of the CYP2B6, CYP3A4, GST and MDR1 in the general population of Mali and in HIV+ patients. - To determine the influence of genotypes and haplotypes of these genes on viral load and CD4 count, - Determine the influence of genotypes and haplotypes of these genes on the concentration of concentration of ARVs - Determine the influence of genotypes and haplotypes of these genes on ARV toxicity.4 - To study the influence of these genes on the occurrence of opportunistic infections

Study Design

- Recruitment of healthy subjects It is known that the frequency of SNPs varies considerably from one population to another. Certain SNPs may be involved in the variability of responses to treatment in a population and not in another. Therefore, the interest to establish their frequencies in each population to better assess their medical implications. However, these data are missing for our population. In addition, the determination of the frequency of alleles and genotypes in the healthy population helps to target the most frequent SNPs. Their determination in a healthy population may be useful for a better orientation of the pharmacogenetic study and avoiding bias due to sample selections. In the proposed study, we will recruit after obtaining the informed consent healthy male and female adult volunteers aged between 18-75 years (age and sex matched to the HIV + patients) in Bamako from the teaching hospital of Point G (CHU Point G) where HIV+ patients will be recruited. - Recruitment of HIV+ patients Obviously, Malians patients living with HIV/AIDS have free access to ARVs. However, serious problems have been observed and recorded regarding to the patients' adherence to ARVs due mainly to side effects and toxicity. Despite the vast experience of clinicians in managing HIV+ patients, some patients fail to achieve the expected ARV treatment outcome and are then subject to several changes in the therapeutic option (ARV regimen). From the discussions with clinicians, most ignore the influence of genes on the response to ARVs. Thus, the present proposal is certainly welcomed to understand the influence of candidate genes on the responses to ARVs.

Project Summary

The introduction of highly active antiretroviral therapy (HAART) in the management of acquired immunodeficiency syndrome (AIDS) reduced the morbidity and mortality related to the human immunodeficiency virus infection and transformed AIDS into a chronic disease worldwide. However, the occurrence in certain patients of invalidating side effects or resistance related to antiretroviral (ARVs) treatment may be a source of nonadherence and results in an inadequate response. These differences in treatment response observed in patients could be due to various factors (age, gender, and ethnicity). However, genetic factors play a significant role in the variability of the response to treatment. Like other drugs, ARVs are metabolized by enzymes encoded by polymorphic genes. Thus, inter-individual differences in DNA sequence as a result of single nucleotide polymorphisms (SNP) may explain the variability of therapeutic responses. The most relevant enzymatic classes influencing drug metabolism are the cytochrome P450, the multidrug resistance gene-1 (MDR-1) and the glutathione S-transferase (GST). This project will focus on the pharmacogenetics aspects of the ARV treatment, and will investigate the impact of selected SNPs from the above mentioned three major classes of drug metabolising enzymes.

Host Organisation

Department Institution Country
Universite des Sciences des Techniques et des Technoloquies de Bamako Mali

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