Harjani Raj, Malkani Ram
Department of HIV/AIDS, Rajiv Gandhi Medical College and Chhatrapati Shivaji Maharaj Hospital, Thane, Maharashtra, India.
Department of Dermatology, Jaslok Hospital, Mumbai, Maharashtra, India.
Indian J Sex Transm Dis AIDS. 2016 Jul-Dec;37(2):167-172. doi: 10.4103/0253-7184.192124.
About 10% of the patients had surveillance drug-related mutations for nonnucleoside reverse transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs) in an Indian study. It was also reported that resistance was maximum for nucleoside reverse transcriptase inhibitors (NRTIs) and minimum for PIs.
The present study was a cross-sectional assessment of 21 human immunodeficiency virus (HIV)-infected individuals attending a HIV care center in a tertiary care center in Mumbai, Maharashtra, India. All HIV-infected individuals included in the present analysis were tested for CD4 count, viral load, and resistance to antiretrovirals (ARVs).
A total of 13 male and 8 female were included in the present analysis. Of these, 18 were treatment naive and three were treatment experienced patients. In treatment-naive patients, the proportion of high-level resistance (HLR) was 2% for NRTIs, 5% for PIs, and 11% for NNRTIs. In treatment-naive patients, high susceptibility was observed for darunavir (89%) followed by lopinavir (72%) and fosamprenavir (67%) among PIs. Similarly, susceptibility was high for NRTIs lamivudine (94%), emtricitabine (94%), and tenofovir (89%). However, we found HLR for nevirapine (39%) even in treatment-naive patients.
The proportion of HLR was relatively low for PIs and NRTIs, compared with NNRTIs in treatment-naive patients. We also reported a high correlation in resistance patterns among drugs belonging to the same group. Thus, it may be useful to conduct ARV resistance even in newly infected HIV patients and those receiving medications for the first time.
在一项印度研究中，约10%的患者存在针对非核苷类逆转录酶抑制剂（NNRTIs）和蛋白酶抑制剂（PIs）的监测药物相关突变。另据报道，核苷类逆转录酶抑制剂（NRTIs）的耐药性最高，而PIs的耐药性最低。
本研究是对印度马哈拉施特拉邦孟买一家三级医疗中心的HIV护理中心的21名人类免疫缺陷病毒（HIV）感染者进行的横断面评估。纳入本分析的所有HIV感染者均接受了CD4细胞计数、病毒载量和抗逆转录病毒药物（ARVs）耐药性检测。
本分析共纳入13名男性和8名女性。其中，18名患者未接受过治疗，3名患者接受过治疗。在未接受过治疗的患者中，NRTIs的高水平耐药（HLR）比例为2%，PIs为5%，NNRTIs为11%。在未接受过治疗的患者中，PI类药物中达芦那韦的敏感性较高（89%），其次是洛匹那韦（72%）和福沙普那韦（67%）。同样，NRTIs类药物中拉米夫定（94%）、恩曲他滨（94%）和替诺福韦（89%）的敏感性较高。然而，我们发现即使在未接受过治疗的患者中，奈韦拉平的HLR也为39%。
在未接受过治疗的患者中，与NNRTIs相比，PIs和NRTIs的HLR比例相对较低。我们还报告了同一组药物之间耐药模式的高度相关性。因此，即使在新感染的HIV患者和首次接受药物治疗的患者中进行ARV耐药性检测可能也是有用的。
