Evaluation of Acquired HIV Drug Resistance among People Living with HIV Who Have Taken Antiretroviral Therapy for 9–15 Months in 14 Triangular Clinics in Iran, 2015–2016

Abstract

Aims: The aim of this study was to evaluate drug resistance patterns among Iranian people living with HIV who have taken antiretroviral therapy for 9–15 months. Methods: A cross-sectional study was conducted between December 2015 and May 2016. Two hundred fifty-two blood samples were collected from all eligible HIV-infected patients at fourteen healthcare settings, located in major provinces in Iran. The samples were examined for presence of drug resistance strains and viral load level. Moreover, a phylogenetic tree, using neighbor joining, was constructed and HIV subtypes were determined. Results: The most common subtypes were CRF35-AD (47.6%) and A1 (42.8%), followed by 45_CPX (4.8%) and C (4.8%). The resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs), and protease inhibitors was reported as 19.2, 19.2, and 10.3%, respectively. M184I/V mutation was the most frequent (31.6%) mutation among NRTI-based regimens. Moreover, K103E/N was the most frequent (34.2%) NNRTI mutation. Conclusions: This is the first study to illuminate the emergence of the CPX genotype among Iranian patients. The drug resistance rate of NNRTIs was similar to that of NRTIs. By assessing drug resistance, it is possible to evaluate the efficacy of treatment and patient adherence to treatment.

‘You just prefer to die early!’: how socioecological context impedes treatment for people living with HIV in Iran

“…Previous studies from MENA, most of which are from Iran, are largely composed of quantitative surveys, producing lists of risk and protective factors for treatment adherence. [7][8][9][10][11][12][13][14] Our findings suggest that the three key affective and cognitive mechanisms of denial, fear and despair undermine successful and lifelong treatment. We detail the ways in which denial and fear are triggered through a context of negative societal perceptions, lack of awareness regarding HIV and widespread misinformation.…”

“…Protected by copyright. BMJ Global Health few studies conducted within MENA, most focus on prevalence or biomedical aspects of the condition, [7][8][9][10] and studies of adherence focus on identifying key affected populations, such as people who use drugs and imprisoned individuals at risk of non-adherence. 11 12 Quantitative and biomedical studies promote understanding about the prevalence and risk profiles of non-adherence among key affected groups, 13 14 and can increase knowledge on drug resistance profiles to antiretroviral therapy in different settings.…”

“…11 12 Quantitative and biomedical studies promote understanding about the prevalence and risk profiles of non-adherence among key affected groups, 13 14 and can increase knowledge on drug resistance profiles to antiretroviral therapy in different settings. 8 Yet, there is a need for qualitative studies for identifying how and why engagement with and adherence to treatment decline, in addition to elucidating the pathways that lead from the sociocultural, political and economic context to individual reasonings and reactions that determine behaviour. Studies from other regions provide evidence within the socioecological framework of multiple influences on lifelong antiretroviral use.…”

Plasma and semen viral loads discordance in HIV-positive patients receiving antiretroviral treatment (ART) in Tehran: an implication for a healthy pregnancy

“…Several factors are contributed to semen viral persistence, including HIV drug resistance [1], coinfection with other STDs, such as urethritis [1,32], and insufficient potencies, absorption, and penetration of ART drugs [33]. Recently, the Swiss National AIDS Commission announced that HIV-positive patients are not having other STDs, undetectable BP viral load for at least six months, and good adherence to ART regimens are sexually non-infectious [34][35][36][37][38][39][40].…”