Abstract
A major cause of failure of antiretroviral therapy (ART) is the presence of drug-resistance-associated mutations in the polymerase gene of HIV-1. The paucity of data regarding potential drug resistance to reverse transcriptase inhibitors (RTIs) prompted us to carry out this study. This information will shed light on the extent of drug resistance already present in HIV strains and will give future directions in patient treatment and in drug design. Drug resistance genotyping of a partial reverse transcriptase gene was done in 103 HIV-1-infected patients, including the ART-naive and ART-experienced population. The drug resistance pattern was analyzed using the Stanford HIV-DR database, the IAS-USA mutation list and the REGA algorithm-v8.0. Subtyping was done using the REGA HIV-1 subtyping tool-v2.01. The majority of our sequences (96 %) were found to be subtype C, and four (3.8 %) were subtype A1. Significant prevalence of DR mutations (28 %) was observed in the RT gene. Major amino acid substitutions were seen at positions 41, 90, 98, 103, 106, 108, 138, 181, 184, 190, 215, and 219, which confer high/intermediate levels of resistance to most RTIs, independently or together. Our results show that there is an urgent need to tailor ART drug regimens to the individual to achieve optimum therapeutic outcome in North India.
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Acknowledgments
This work was partially supported by grants from the Indian Council of Medical Research (ICMR), India. We are also thankful to Super Religare Laboratories Ltd., Gurgaon, Haryana (India) for quantifying the HIV viral load in some patients.
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The authors declare that there are no conflicts of interest.
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This study was approved by the Institutional Ethics Committee (Reference No. D.No.1192/FM on 27 August, 2011), Jawaharlal Nehru Medical College (J.N.M.C), Faculty of Medicine, Aligarh Muslim University (A.M.U), Aligarh-INDIA.
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Abida Malik and Arvind Rai these authors contributed equally to this work.
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Azam, M., Malik, A., Rizvi, M. et al. Trends of drug-resistance-associated mutations in the reverse transcriptase gene of HIV type 1 isolates from North India. Arch Virol 159, 719–725 (2014). https://doi.org/10.1007/s00705-013-1889-y
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DOI: https://doi.org/10.1007/s00705-013-1889-y