Antiretroviral drug resistance mutations in naïve and experienced patients in Shiraz, Iran, 2014.

Abstract:

:Resistance to antiretroviral agents is a significant concern in the clinical management of HIV-infected individuals, particularly in areas of the world where treatment options are limited. In this study, we aimed to identify HIV drug-resistance-associated mutations in 40 drug-naïve patients and 62 patients under antiretroviral therapy (ART) referred to the Shiraz HIV/AIDS Research Center - the first such data available for the south of Iran. HIV reverse transcriptase and protease genes were amplified and sequenced to determine subtypes and antiretroviral- resistance-associated mutations (RAMs). Subtype CRF35-AD recombinant was the most prevalent in all patients (98 of 102, 96 %), followed by subtype A1, and subtype B (one each, 2 %). Among the 40 ART-naïve patients, two mutations associated with nucleoside reverse transcriptase inhibitor (NRTI) resistance (two with Y115F and T215I) and three associated with non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance (two with G190S and Y181C, four with V179T) were found. Among ART-experienced patients, four mutations associated with resistance to NRTI, four with NNRTI, and five with protease inhibitors (PI) were found. Twenty patients with high levels of resistance were already on second-line therapy. We document for the first time in this region of Iran high levels of ART resistance to multiple drugs. Our findings call for more vigilant systematic ART resistance surveillance, increased resistance testing, careful management of patients with existing regimens, and strong advocacy for expansion of available drugs in Iran.

journal_name

Arch Virol

journal_title

Archives of virology

authors

Naziri H,Baesi K,Moradi A,Aghasadeghi MR,Tabarraei A,McFarland W,Davarpanah MA

doi

10.1007/s00705-016-2955-z

subject

Has Abstract

pub_date

2016-09-01 00:00:00

pages

2503-9

issue

9

eissn

0304-8608

issn

1432-8798

pii

10.1007/s00705-016-2955-z

journal_volume

161

pub_type

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