Drug resistance profile and subtyping of HIV-1 RT gene among Iranian under-treatment patients

Document Type: Research Paper

Authors

1 Department of Virology, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box 14115-331, Tehran, I.R. Iran.

2 Infectious Disease Division, Imam Khomeini Hospital, Tehran University of Medical Sciences, P.O. Box 14198, Tehran, I.R. Iran.

Abstract

Identification of drug resistant mutations is important in the management of HIV-1 infected patients. The aim of the current study was to evaluate drug resistance profile of RT gene and assess subtype among HIV-1 circulating strains and intensification of physician’s options for the best therapy. HIV-1 RNA of 25 samples
was extracted from plasma and RT Nested- PCR was performed and the final products were sequenced and
phylogenetically analyzed. Stanford HIV drug resistance sequence database was used for interpretation
of the data. The results of phylogenetic analysis showed subtypes A1 and B in 14 (58%) and 10 (42%)
patients respectively. Of the 24 patients, 23 (95%) had resistance to NRTIs, 8 individuals (32%) to NNRTIs
and one patient was susceptible to NRTIs as well as NNRTIs. The drug resistance interpretation in this
study showed: 87.7% susceptible for AZT, 70.8% susceptible, and 25% high-level resistance for 3TC,
87.7% susceptible for TDF, 29.1% high-level resistance for NVP and 70.8% susceptible and 25% highlevel
resistance for EFV. Our data suggests that probably, the use of 2 NRTIs plus 1 protease inhibitor (PI)
regimen is more effective than 2 NRTIs plus 1 NNRTI regimen in Iranian patients that use 2 NRTI plus
NNRTI regimen and also continuous surveillance should be perform to evaluate resistance patterns for
more effective therapeutic approaches.

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