Sinha S, Ahmad H, Shekhar R C, Kumar N, Dar L, Samantaray J C, Sharma S K, Bhargava A, Pandey R M, Mitsuyasu R L, Fahey J L
Department of Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
AIDS Res Treat. 2012;2012:905823. doi: 10.1155/2012/905823. Epub 2012 Mar 15.
Objective. The increased use of antiretroviral therapy (ART) has reduced the morbidity and mortality associated with HIV, adversely leading to the emergence of HIV drug resistance (HIVDR). In this study we aim to evaluate the prevalence of HIVDR mutations in ART-naive HIV-1 infected patients from northern India. Design. Analysis was performed using Viroseq genotyping system based on sequencing of entire protease and two-thirds of the Reverse Transcriptase (RT) region of pol gene. Results. Seventy three chronic HIV-1 infected ART naïve patients eligible for first line ART were enrolled from April 2006 to August 2008. In 68 patients DNA was successfully amplified and sequencing was done. 97% of HIV-1 strains belonged to subtype C, and one each to subtype A1 and subtype B. The overall prevalence of primary DRMs was 2.9% [2/68, 95% confidence interval (CI), 0.3%-10.2%]. One patient had a major RT mutation M184V, known to confer resistance to lamivudine, and another had a major protease inhibitor (PI) mutation D30N that imparts resistance to nelfinavir. Conclusion. Our study shows that primary HIVDR mutations have a prevalence of 2.9% among ART-naive chronic HIV-1 infected individuals.
目的。抗逆转录病毒疗法(ART)使用的增加降低了与HIV相关的发病率和死亡率,但不利的是导致了HIV耐药性(HIVDR)的出现。在本研究中,我们旨在评估印度北部初治的HIV-1感染患者中HIVDR突变的流行情况。设计。使用基于pol基因整个蛋白酶和三分之二逆转录酶(RT)区域测序的Viroseq基因分型系统进行分析。结果。2006年4月至2008年8月,纳入了73例符合一线ART治疗条件的慢性HIV-1感染初治患者。68例患者的DNA成功扩增并进行了测序。97%的HIV-1毒株属于C亚型,A1亚型和B亚型各有1株。原发性耐药相关突变(DRMs)的总体流行率为2.9%[2/68,95%置信区间(CI),0.3%-10.2%]。1例患者有已知对拉米夫定耐药的主要RT突变M184V,另1例有对奈非那韦耐药的主要蛋白酶抑制剂(PI)突变D30N。结论。我们的研究表明,在初治的慢性HIV-1感染个体中,原发性HIVDR突变的流行率为2.9%。