Archives of Virology

, Volume 161, Issue 9, pp 2503–2509 | Cite as

Antiretroviral drug resistance mutations in naïve and experienced patients in Shiraz, Iran, 2014

  • Hamed Naziri
  • Kazem BaesiEmail author
  • Abdolvahab MoradiEmail author
  • Mohammad R. Aghasadeghi
  • Alijan Tabarraei
  • Willi McFarland
  • Mohamad Ali Davarpanah
Original Article


Resistance to antiretroviral agents is a significant concern in the clinical management of HIV-infected individuals, particularly in areas of the world where treatment options are limited. In this study, we aimed to identify HIV drug-resistance-associated mutations in 40 drug-naïve patients and 62 patients under antiretroviral therapy (ART) referred to the Shiraz HIV/AIDS Research Center – the first such data available for the south of Iran. HIV reverse transcriptase and protease genes were amplified and sequenced to determine subtypes and antiretroviral- resistance-associated mutations (RAMs). Subtype CRF35-AD recombinant was the most prevalent in all patients (98 of 102, 96 %), followed by subtype A1, and subtype B (one each, 2 %). Among the 40 ART-naïve patients, two mutations associated with nucleoside reverse transcriptase inhibitor (NRTI) resistance (two with Y115F and T215I) and three associated with non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance (two with G190S and Y181C, four with V179T) were found. Among ART-experienced patients, four mutations associated with resistance to NRTI, four with NNRTI, and five with protease inhibitors (PI) were found. Twenty patients with high levels of resistance were already on second-line therapy. We document for the first time in this region of Iran high levels of ART resistance to multiple drugs. Our findings call for more vigilant systematic ART resistance surveillance, increased resistance testing, careful management of patients with existing regimens, and strong advocacy for expansion of available drugs in Iran.


Nucleotide Analogue Reverse Transcriptase Inhibitor Darunavir Transmitted Drug Resistance Kaletra Protease Inhibitor Mutation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



The authors would like to acknowledge Golestan University of Medical Sciences for financial support.

Compliance with ethical standards

Funding source

Golestan University of Medical Sciences.


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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  • Hamed Naziri
    • 1
    • 2
  • Kazem Baesi
    • 3
    Email author
  • Abdolvahab Moradi
    • 2
    Email author
  • Mohammad R. Aghasadeghi
    • 3
  • Alijan Tabarraei
    • 2
  • Willi McFarland
    • 4
  • Mohamad Ali Davarpanah
    • 5
  1. 1.Department of Virology, School of Public HealthTehran University of Medical SciencesTehranIran
  2. 2.Department of Microbiology, School of MedicineGolestan University of Medical SciencesGorganIran
  3. 3.Department of Hepatitis and AIDSPasteur Institute of IranTehranIran
  4. 4.Department of Epidemiology and BiostatisticsUniversity of California, San FranciscoSan FranciscoUSA
  5. 5.Shiraz HIV and AIDS Research CenterShiraz University of Medical SciencesShirazIran

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