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Antiretroviral drug resistance among antiretroviral‐naïve and treatment experienced patients infected with HIV in Iran
Author(s) -
Baesi Kazem,
Ravanshad Mehrdad,
Ghanbarisafari Maryam,
Saberfar Esmaeil,
SeyedAlinaghi SeyedAhmad,
Volk Jonathan E.
Publication year - 2014
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.23898
Subject(s) - efavirenz , resistance mutation , hiv drug resistance , drug resistance , medicine , viral load , lopinavir , virology , antiretroviral therapy , human immunodeficiency virus (hiv) , biology , polymerase chain reaction , reverse transcriptase , microbiology and biotechnology , genetics , gene
Resistance to antiretroviral therapy (ART) threatens the success of programs to reduce HIV morbidity and mortality, particularly in countries with few treatment options. In the present study, genotype and phenotype data from ART‐naïve and experienced hospitalized patients infected with HIV in Tehran, Iran were used to assess the prevalence and types of transmitted (TDR) and acquired drug resistance (ADR) mutations. All 30 participants naïve to ART and 62 of 70 (88.6%) participants receiving ART had detectable viral loads. Among participants receiving ART with sequencing data available (n = 62), 36 (58.1%) had at least one drug resistance mutation; the most common mutations were K103N (21.0%), M184V (19.4%), and the thymidine analogue mutations. Seven (11.3%), 27 (43.5%), and two (3.2%) of these participants had resistance to one, two, and three drug classes, respectively. High‐level resistance to efavirenz (EFV) was more common among participants on EFV‐based regimens than high‐level lopinavir/ritonivar (LPV/r) resistance among those on LPV/r‐based regimens (55.3% vs. 6.7%, P < 0.0001). Two (6.7%) antiretroviral‐naïve participants had K103N mutations. These findings document an alarmingly high frequency of multiple HIV drug class resistance in Iran, confirm the presence of TDR, and highlight the need for systematic viral load monitoring and drug resistance testing, including at diagnosis. Expanded access to new antiretroviral medications from additional drug classes is needed. J. Med. Virol. 86:1093–1098, 2014 . © 2014 Wiley Periodicals, Inc.