HIV-1 genetic diversity and transmitted drug resistance frequency among Iranian treatment-naive, sexually infected individuals

Abstract

In recent years, the patterns of human immunodeficiency virus 1 (HIV-1) transmission in Iran have been changing gradually from drug injection to unprotected sexual contact. This study sought to investigate the phylogenetic trends and characteristics of transmitted drug resistance (TDR) mutations of HIV-1 in a population that is mainly infected through homo/heterosexual contacts. Sixty newly diagnosed antiretroviral-naive individuals with HIV infection living in Tehran were recruited to this survey, and among them, 42 subjects were established to be infected through sexual intercourse. Following amplification and sequencing of the main part of the HIV-1 pol region, phylogenetic and drug-resistance mutation (DRM) analysis was successfully performed on these 42 patients. Phylogenetic analysis showed that the majority of the subjects were infected with subtype CRF35_AD (88%), followed by subtype B, with 7.1%, and subtype CRF01_AE, with 4.7%. A total of 7.1% of the subjects were found to be infected with HIV-1 variants with surveillance drug-resistant mutations (SDRMs) according to the last world health organisation (WHO) algorithm. All of the identified SDRMs belonged to the non-nucleoside reverse transcriptase inhibitors (NNRTIs) class, including K103 N and V106A, which were found in three patients. Two minor HIV protease-inhibitor-related mutations (L10I and G73S) were detected in two patients, but these mutations are not included in the WHO SDRMs list. The dominance of HIV-1 subtype CRF35_AD was observed among subjects of this study who were infected through sexual contact. The moderate prevalence of SDRMs (7.1%) in this population emphasises the fact that the risk of treatment failure in HIV-infected individuals might increase in the future, and preventive measures should be considered by health authorities.

HIV-1 reverse transcriptase and protease mutations for drug-resistance detection among treatment-experienced and naïve HIV-infected individuals

“…In the current study, the prevalence of SDRMs was 8.3% in ART-naïve subjects; therefore, the study subjects are classified in the WHO moderate category in terms of the presence of SDRMs. The present study findings were consistent with those of the previous studies in Iran (primary resistance of 5%-15%) [11,19,20]. This finding was not surprising considering that NRTIs are available since 1997 and widely distributed in Iran as an essential part of ART regimens.…”

“…In the present study, the prevalence of primary resistance among ART-naive Iranian patients (8.3%) was lower than that of many other countries [Germany (17.2%) [23], Greece (16.9%) [24], Brazil (13.3%) [25], and France (10.8%) [26]], but it seems to be rising when compared to previous reports from Iran [11,19,20,27].…”

“…The plasma of all specimens was separated from the whole blood and kept at -80˚C utile use. The HIV-1 viral load of participants was measured using a method described elsewhere [11]. The plasma samples of eight patients with HIV infection and eight healthy participants were used as positive and negative controls, respectively.…”

“…Then, the PCR product was re-amplified with inner primers (forward primer [K4] and reverse primer [U12]) with LA Taq DNA polymerase (TaKaRa Bio Inc., Shiga, Japan), [13,14]. The HIV-1 DRMs were detected according to the method described previously [11].…”

Presence of different hepatitis C virus genotypes in plasma and peripheral blood mononuclear cell samples of Iranian patients with HIV infection

“…Interestingly, besides reducing HIV transmission through intravenous drug abuse, sexual transmission had been increasing (36.8%) . Since infection with HCV through sexual transmission is an infrequent event, it seemed the number of HIV/HCV co‐infection will be reduced in Iran in the future . In this study, 55 (39.3%) of the HIV‐infected patients had a history of unprotected sex and were presumably infected with HIV through sexual intercourse.…”