Trends in transmitted HIV drug resistance in Iran from 2010 to 2011

In: Journal of the International AIDS Society, Band 15, Heft S4, S. 1-1

Abstract

BackgroundDrug‐resistant (DR) HIV emerges during antiretroviral treatment (ART), creating concern about widespread transmission of DR‐HIV as ART is expanded in resource‐limited countries. The aim of this study was to determine the predominant HIV‐1 subtypes and prevalence of drug‐resistance mutations among antiretroviral‐naïve patients in Iran.Design and methodsFor this HIV DR threshold surveillance study, blood samples were collected from 50 antiretroviral‐naïve HIV‐1‐infected patients. Antiretroviral‐resistant mutations were determined by sequencing HIV‐1 protease (PR), reverse transcriptase (RT) and integrase (INT) regions. The HIV‐1 subtype of each sample was determined by sequencing the p17 and C2‐V5 regions of the gag and env genes, respectively.ResultsThe PR, RT and INT regions were successfully sequenced in 47 samples (94.0%). Phylogenetic analyses of these regions revealed that 45 (95.7%) cases were CRF35_AD. The remaining two cases were subtype B (2.1%) and CRF01_AE (2.1%). Consistent results were obtained also by Env and Gag sequences. Regarding prevalence of transmitted drug‐resistant viruses, two cases were found to harbor RT‐inhibitor mutations. In addition, nine amino acid differences compared to that of HXB2 were found in protease region as compared to that of HXB2, though none matched with the mutations shown in the WHO list for surveillance of transmitted mutations. No drug‐resistant mutations were found in the INT region.ConclusionOur study clarified that CRF35_AD is the major HIV‐1 subtype among Iranian HIV‐1‐infected patients. According to the WHO surveillance algorithm, the prevalence of transmitted drug resistance in Iran was estimated as moderate (5–15%).