Krishnan K Mohana, Amsavathani Sk
Department of Microbiology, Sri Muthukumaran Medical College and Research Institue, Mangadu, Chennai, India.
J Glob Infect Dis. 2012 Apr;4(2):110-3. doi: 10.4103/0974-777X.96775.
The number of people living with human immunodeficiency virus (HIV) is increasing day by day in India. The disease has now spread from urban areas to rural areas. The proof reading of the reverse transcriptase enzyme is poor, which may lead to genetic diversity within the HIV strains, which in turn leads to problems like failure or resistance in antiretroviral treatment. This study is designed to find out the polymorphisms of the reverse transcriptase gene of HIV, after the native drug pressure among antiretroviral therapy (ART) naïve rural people living with HIV/AIDS (RPLHA).
A total of 207 HIV-Reactive patients were allowed to take native drugs from the local area and were advised to attend the center for HIV after six months for a follow-up. At the time of the follow-up visit, a second blood sample was taken from 20 reactive native-drug exposed ART-naïve patients. The plasma was separated and transported at 20°C to the YRG Care Center for genotyping.
Among the 20 HIV-reactive samples processed for gene sequencing analysis to detect the genotypic variations, only one sample (5%) showed high-level mutational resistance variations and the predominant polymorphisms detected were V35T (100%), K122E (94.44%), and V60I (88.88%).
The presence of drug-resistance mutations, although minimal, was important, as the drug-resistant strains could spread among the RPLHA and to their sexual partners. There was a definite need to generate a drug resistance database and the polymorphic pattern of Indian strains concern to the future clinical management of the disease, and a vaccine design to contain the disease.
在印度，感染人类免疫缺陷病毒（HIV）的人数日益增加。该疾病现已从城市地区蔓延至农村地区。逆转录酶的校对功能欠佳，这可能导致HIV毒株内出现基因多样性，进而引发抗逆转录病毒治疗失败或耐药等问题。本研究旨在了解在未接受过抗逆转录病毒治疗（ART）的农村HIV/AIDS患者（RPLHA）中，在当地药物压力作用后，HIV逆转录酶基因的多态性情况。
共207名HIV反应性患者被允许服用当地药物，并被建议6个月后到HIV中心进行随访。在随访时，从20名接受过当地药物治疗且未接受过ART的反应性患者中采集第二份血样。分离血浆并在20°C下运至YRG护理中心进行基因分型。
在为检测基因变异而进行基因测序分析的20份HIV反应性样本中，只有1份样本（5%）显示出高水平的突变耐药变异，检测到的主要多态性为V35T（100%）、K122E（94.44%）和V60I（88.88%）。
耐药突变的存在虽然极少，但很重要，因为耐药毒株可能在RPLHA及其性伴侣中传播。确实需要建立一个耐药数据库，以及印度毒株的多态性模式对于该疾病未来的临床管理和控制该疾病的疫苗设计都至关重要。
