Jarchi Maryam, Bokharaei-Salim Farah, Esghaei Maryam, Kiani Seyed Jalal, Jahanbakhsh Fatemeh, Monavari Seyed Hamidreza, Ataei-Pirkooh Angila, Marjani Arezoo, Keyvani Hossein
Department of Virology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
Department of Virology, Pasteur Institute of Iran, Tehran, Iran.
Curr HIV Res. 2019;17(6):397-407. doi: 10.2174/1570162X17666191106111211.
The advent of resistance-associated mutations in HIV-1 is a barrier to the success of the ARTs.
In this study, the abundance of HIV-1 infection in Iranian children, and also detection of the TDR in naïve HIV-1 infected pediatric (under 12 years old) were evaluated.
From June 2014 to January 2019, a total of 544 consecutive treatment-naïve HIV-1- infected individuals enrolled in this study. After RNA extraction, amplification, and sequencing of the HIV-1 pol gene, the DRM and phylogenetic analysis were successfully performed on the plasma specimens of the ART-naïve HIV-1-infected-children under 12 years old. The DRMs were recognized using the Stanford HIV Drug Resistance Database.
Out of the 544 evaluated treatment-naïve HIV-1-infected individuals, 15 (2.8%) cases were children under 12 years old. The phylogenetic analyses of the amplified region of pol gene indicated that all of the 15 HIV-1-infected pediatric patients were infected by CRF35_AD, and a total of 13.3% (2/15) of these children were infected with HIV-1 variants with SDRMs (one child harbored two related SDRMs [D67N, V179F], and another child had three related SDRMs [M184V, T215F, and K103N]), according to the last algorithm of the WHO. No PIs-related SDRMs were observed in HIV-1-infected children.
The current study demonstrated that a total of 13.3% of treatment-naïve HIV-1-infected Iranian pediatrics (under 12 years old) were infected with HIV-1 variants with SDRMs. Therefore, it seems that screening to recognize resistance-associated mutations before the initiation of ARTs among Iranian children is essential for favorable medication efficacy and dependable prognosis.
HIV-1中耐药相关突变的出现是抗逆转录病毒治疗（ARTs）成功的障碍。
在本研究中，评估了伊朗儿童中HIV-1感染的丰度，以及初治HIV-1感染儿科患者（12岁以下）中耐药性的检测情况。
2014年6月至2019年1月，共有544例连续的初治HIV-1感染个体纳入本研究。在对HIV-1 pol基因进行RNA提取、扩增和测序后，成功地对12岁以下初治HIV-1感染儿童的血浆标本进行了耐药相关突变（DRM）和系统发育分析。使用斯坦福HIV耐药数据库识别DRM。
在544例评估的初治HIV-1感染个体中，15例（2.8%）为12岁以下儿童。pol基因扩增区域的系统发育分析表明，所有15例HIV-1感染儿科患者均感染了CRF35_AD，根据世界卫生组织的最新算法，这些儿童中有13.3%（2/15）感染了具有耐药相关突变的HIV-1变体（一名儿童携带两个相关的DRM [D67N，V179F]，另一名儿童有三个相关的DRM [M184V，T215F和K103N]）。在HIV-1感染儿童中未观察到与蛋白酶抑制剂（PIs）相关的DRM。
本研究表明，12岁以下初治HIV-1感染的伊朗儿科患者中，共有13.3%感染了具有耐药相关突变的HIV-1变体。因此，在伊朗儿童开始抗逆转录病毒治疗之前进行筛查以识别耐药相关突变，对于良好的药物疗效和可靠的预后似乎至关重要。
