Antiretroviral Drug Resistance Mutations among HIV Treatment Failure Patients in Tehran, Iran
AbstractBackground: This study aimed to determine drug resistance mutations in patients with virological failure and find correlation between HIV drug resistance test and viral load.Methods: Blood sample was collected from 51 patients who suspicious treatment failure in the center of Imam Khomeini Hospital, Tehran, Iran in 2015. Viral voluntary counseling and testing load test was done and the patients with viral load above 1000 copies choose for detection of drug resistance mutations by genotyping method (29 patients).Results: The majority of patients (82.75) harbored the HIV subtype CRF 35 A-D. The 86.2% patients compromised at least one resistance mutation. The analysis of reverse transcriptase showed M184V (68.9%), T215YISF (44.8%), K103N (27.6%) and the analysis results of protease revealed G73SC (13.8%) and I47VA (6.9%). Eventually, the significant correlation between viral load and drug resistance was found.Conclusion: The result of our research stress the significance of recognizing drug resistant on time that prohibits the accumulation of drug resistance mutation and circulates the resistance strain of HIV-1 virus and the importance of national study according to the reliable findings for treatment guidelines.
Paydary K, Khaghani P, Emamzadeh-Fard S, Alinaghi SAS, Baesi K (2013). The emergence of drug resistant HIV variants and novel anti–retroviral therapy. Asian Pac J Trop Biomed, 3:515-522.
Baesi K, Ravanshad M, Ghanbarisafari M, et al (2014). Antiretroviral drug resistance among antiretroviral‐naïve and treatment experienced patients infected with HIV in Iran. J Med Virol, 86:1093-8.
Pillay D (2001). The emergence and epidemiology of resistance in the nucleoside-experienced HIV-infected population. Antivir Ther, 6 Suppl 3:15-24.
Lawrence J, Mayers DL, Hullsiek KH, et al (2003). Structured treatment interruption in patients with multidrug-resistant human immunodeficiency virus. N Engl J Med, 349:837-846.
Dybul M, Fauci AS, Bartlett JG, et al (2002). Guidelines for using antiretroviral agents among HIV-infected adults and adolescents. Ann Intern Med, 137(5 Pt 2):381-433.
Deeks SG (2000). Determinants of virological response to antiretroviral therapy: implications for long-term strategies. Clin Infect Dis, 30 Suppl 2:S177-84.
Unicef WHO (2009). Towards universal access: Scaling up priority HIV/AIDS interventions in the health sector.
Ndembi N, Goodall RL, Dunn DT, et al (2010). Viral rebound and emergence of drug resistance in the absence of viral load testing: a randomized comparison between zidovudine-lamivudine plus Nevirapine and zidovudine-lamivudine plus Abacavir. J Infect Dis, 201:106-13.
Jahanbakhsh F, Hattori J, Matsuda M, et al (2013). Prevalence of transmitted HIV drug resistance in Iran between 2010 and 2011. PLoS One, 8(4):e61864.
Seu L, Mulenga LB, Siwingwa M, et al (2015). Characterization of HIV drug resistance mutations among patients failing first‐line antiretroviral therapy from a tertiary referral center in Lusaka, Zambia. J Med Virol, 87:1149-57.
Baesi K, Ravanshad M, Hosseini Y, Abdolbaghi MH (2012). Drug resistance profile and subtyping of HIV-1 RT gene in Iranian patients under treatment. Iran J Biotechnol, 10:1-7.
Elliott JH, Pujari S (2008). Protease inhibitor therapy in resource-limited settings. Curr Opin HIV AIDS, 3:612-9.
Manosuthi W, Ongwandee S, Bhakeecheep S, et al (2015). Guidelines for antiretroviral therapy in HIV-1 infected adults and adolescents 2014, Thailand. AIDS Res Ther, 12:12.
Organization WH (2010). Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach-2010 revision. http://apps.who.int/iris/bitstream/10665/44379/1/9789241599764_eng.pdf
Group AARS (2008). PCR and sequencing procedures: HIV-1. Version February 2008.
Naziri H, Baesi K, Moradi A, et al (2016). Antiretroviral drug resistance mutations in naïve and experienced patients in Shiraz, Iran, 2014. Arch Virol, 161:2503–2509.
Islamic Republic of Iran (2015). AIDS Progress Report On Monitoring of the United Nations General Assembly Special Session on HIV and AIDS. http://www.unaids.org/sites/default/files/country/documents/IRN_narrative_report_2015.pdf
Abdissa A, Yilma D, Fonager J, et al (2014). Drug resistance in HIV patients with virological failure or slow virological response to antiretroviral therapy in Ethiopia. BMC Infect Dis, 14:181.
El Annaz H, Recordon-Pinson P, Tagajdid R, et al (2012). Drug resistance mutations in HIV type 1 isolates from patients failing antiretroviral therapy in morocco. AIDS Res Hum Retroviruses, 28:944-8.
Jamjoom GA, Azhar EI, Madani TA, et al (2010). Genotype and antiretroviral drug resistance of human immunodeficiency virus-1 in Saudi Arabia. Saudi Med J, 31:987-92.
Khalili H, Rohani R, Seyedalinaghi S, et al (2012). Adherence to antiretroviral therapy among Iranian HIV/AIDS patients. Curr Clin Pharmacol, 7:111-5.
Winand R, Theys K, Eusébio M, et al (2015). Assessing transmissibility of HIV-1 drug resistance mutations from treated and from drug-naive individuals. AIDS, 29:2045-52.
Sanguansittianant S, Nooroon N, Phaengchomduan P, Ammaranond P (2013). Trends in Prevalence of HIV‐1 Drug Resistance in Thailand 2009–2010. J Clin Lab Anal, 27:346-53.
Gupta R, Hill A, Sawyer AW, Pillay D (2008). Emergence of drug resistance in HIV type 1-infected patients after receipt of first-line highly active antiretroviral therapy: a systematic review of clinical trials. Clin Infect Dis, 47:712-22.
Rawizza HE, Chaplin B, Meloni ST et al (2013). Accumulation of protease mutations among patients failing second-line antiretroviral therapy and response to salvage therapy in Nigeria. PLoS One, 8:e73582.
Van Zyl GU, Liu TF, Claassen M et al (2013). Trends in genotypic HIV-1 antiretroviral resistance between 2006 and 2012 in South African patients receiving first-and second-line antiretroviral treatment regimens. PLoS One, 8:e67188.
Shafer RW, Schapiro JM (2008). HIV-1 drug resistance mutations: an updated framework for the second decade of HAART. AIDS Rev, 10:67-84.
Leng X, Liang S, Ma Y, et al (2014). HIV virological failure and drug resistance among injecting drug users receiving first-line ART in China. BMJ Open, 4:e005886.
Baesi K, Moallemi S, Farrokhi M, et al (2014). Subtype classification of Iranian HIV-1 sequences registered in the HIV databases, 2006-2013. PLoS One, 9:e105098.
Mousavi SM, Hamkar R, Gouya MM et al (2010). Surveillance of HIV drug resistance transmission in Iran: experience gained from a pilot study. Arch Virol, 155:329-34.
Baesi K, Moradbeigi M, Ravanshad M, Baghban A (2016). Phylogeny and drug resistance of HIV PR gene among HIV patients receiving RT inhibitors in Iran. Asian Pac J Trop Biomed, 6:451-454.
Baesi K, Moallemi S, Ravanshad M (2014). Phylogenetic analysis of HIV-1 pol gene: first subgenomic evidence of CRF29-BF among Iranian HIV-1 patients. Asian Pac J Trop Biomed, 4:S617-S620.
Sanders-Buell E, Bose M, Nasir A, et al (2010). Distinct circulating recombinant HIV-1 strains among injecting drug users and sex workers in Afghanistan. AIDS Res Hum Retroviruses, 26:605-8.
Drugs UNOo, Crime (2010). World drug report 2010. ed. United Nations Publications. https://www.unodc.org/documents/wdr/WDR_2010/World_Drug_Report_2010_lo-res.pdf