Skip to main content
SpringerLink
Log in

Comparison of antiretroviral drug resistance among treatment-naive and treated HIV-infected individuals in Shiraz, Iran

  • Original Article
  • Published:
Archives of Virology Aims and scope Submit manuscript

Abstract

The use of anti-retroviral therapy has been effective in controlling the spread of HIV-1, and has prolonged life expectancy, but this success can be affected by the emergence of drug resistance. The main goal of this study was to investigate drug resistance in the reverse transcriptase (RT), and protease (PR) genes among HIV-1 infected individuals. We systematically selected 59 HIV-1 infected individuals from Shiraz Voluntary Counseling and Testing Center (29 treatment- naïve and 30 treated). In this study intravenous drug users older than 18 were included in this study. Using specific primers, nested RT-PCR was performed on RNA extracted from patient samples. The genes targeted for RT and PCR were successfully amplified and sequenced. The sequences of these two genes were compared with mutations related to drug resistance against nucleotide reverse transcriptase inhibitors (NRTI), non-nucleotide reverse transcriptase inhibitors (NNRTI) and protease inhibitors (PI) using the latest database from the International AIDS society – USA, Stanford University, and the patterns were recorded. Among treatment-naïve, the detected NRTI and NNRTI resistance mutations were V179T, V75 M and E138A. V179T causes high level resistance to Efavirenze and Nevirapin. V75 M causes intermediate resistance to Stavudine. Regarding NRTI and NNRTI resistance mutations among treated patients, the most frequent mutation (7%) was M184 V, which causes high level resistance to zidovudin and emtricitabine. The interesting result from this study was the detection of NRTI and NNRTI resistance mutations before the initiation of treatment, which signifies the transmission of resistant strains of virus between individuals. This mutation highlights the importance of drug resistance HIV-1 genotyping before commencing treatment.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Abbreviations

ART:

Ant-Retroviral Therapy

DR:

Drug Resistance

TDR:

Transmitted Drug Resistance

RT:

Reverse Transcriptase

NRTIs:

Nucleoside Reverse Transcriptase Inhibitor

NNRTIs:

Non-Nucleoside Reverse Transcriptase Inhibitor

PI:

Protease Inhibitors

IDU:

Intravenous Drug Use

VCT:

Voluntary Counseling and Testing

AZT:

Zidovudine

3TC:

Lamivudine

EFV:

Efavirenz

NJ:

Neighbor-Joining

References

  1. World Health Organization (2012) HIV drug resistance report. http://www.who.int/hiv/pub/drugresistance/report2012/en/

  2. Joulaei H, Maharlouei N, Salehi M, Kazemi A, Motazedian N (2016) Nutritional status of HIV-infected patients in Fars Province, Southern Iran. J HIV AIDS Soc Serv 15(2):147–157

    Article  Google Scholar 

  3. Clavel F, Hance AJ (2004) HIV drug resistance. N Engl J Med 350(10):1023–1035

    Article  CAS  PubMed  Google Scholar 

  4. Palma AC, Araujo F, Duque V, Borges F, Paixão MT, Camacho R (2007) Molecular epidemiology and prevalence of drugresistance-associated mutations in newly diagnosed HIV-1patients in Portugal. Infect Genet Evol 7(3):391–398 Epub 2007 Feb 8

    Article  CAS  PubMed  Google Scholar 

  5. Coffin JM (1995) HIV population dynamics in vivo: implications for genetic variation, pathogenesis, and therapy. Science 267:483–489

    Article  CAS  PubMed  Google Scholar 

  6. Chan PA, Kantor R (2009) Transmitted drug resistance in non-subtype B HIV-1 infection. HIV Ther 3(5):447–465. doi:10.2217/hiv.09.30

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Zolopa AR, Shafer RW, Warford A et al (1999) HIV-1 genotypic resistance patterns predict response to saquinavir–ritonavir therapy in patients in whom previous protease inhibitor therapy had failed. Ann Intern Med 131(11):813–821

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Baesi K, Ravanshad M, Hosseini Y, Abdolbaghi MH (2012) Drug resistance profile and subtyping of HIV-1 RT gene in Iranian patients under treatment. Iran J Biotechnol 10(1):1–7

    CAS  Google Scholar 

  9. National AIDS Committee Secretariat, Ministry of Health and Medical Education Islamic Republic of Iran AIDS Progress Report (2014). http://www.unaids.org/sites/default/files/en/dataanalysis/knowyourresponse/countryprogressreports/2014countries/IRN_narrative_report_2014_en.pdf

  10. Sarrami-Forooshani R, Das SR, Sabahi F et al (2006) Molecular analysis and phylogenetic characterization of HIV in Iran. J Med Virol 78(7):853–863

    Article  CAS  PubMed  Google Scholar 

  11. Memarnejadian A, Menbari S, Mansouri SA et al (2015) Transmitted drug resistance mutations in antiretroviral-naïve injection drug users with chronic HIV-1 infection in Iran. PLoS One 10(5):e0126955. doi:10.1371/journal.pone.0126955 (e Collection 2015)

    Article  PubMed  PubMed Central  Google Scholar 

  12. Werb D, Mills EJ, Montaner JS, Wood E (2010) Risk of resistance to highly active antiretroviral therapy among HIV-positive injecting drug users: a meta-analysis. Lancet Infect Dis 10(7):464–469. doi:10.1016/S1473-3099(10)70097-9

    Article  PubMed  Google Scholar 

  13. Hirsch MS, Brun-Vézinet F, D’Aquila RT et al (2000) Antiretroviral drug resistance testing in adult HIV-1 infection: recommen-dations of an International AIDS Society-USA Panel. JAMA 283:2417–2426

    Article  CAS  PubMed  Google Scholar 

  14. Bennett DE, Camacho RJ, Otelea D et al (2009) Drug resistance mutations for surveillance of transmitted HIV-1 drug-resistance: 2009 update. PLoS One 4:e4724

    Article  PubMed  PubMed Central  Google Scholar 

  15. Tamura K, Dudley J, Nei M, Kumar S (2007) MEGA4: Molecular evolutionary genetics analysis (MEGA) software version 4.0. Mol Biol Evol 24(8):1596–1599 (epub 2007 May 7)

    Article  CAS  PubMed  Google Scholar 

  16. Jahanbakhsh F, Hattori J, Matsuda M et al (2013) Prevalence of transmitted HIV drug resistance in Iran between 2010 and 2011. PLoS One 8(4):e61864. doi:10.1371/journal.pone.0061864 (print 2013)

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Mousavi SM, Hamkar R, Gouya MM et al (2010) Surveillance of HIV drug resistance transmission in Iran: experience gained from a pilot study. Arch Virol 155(3):329–334. doi:10.1007/s00705-009-0583-6 (Epub 2010 Jan 6)

    Article  CAS  PubMed  Google Scholar 

  18. Gupta R, Hill A, Sawyer AW, Pillay D (2008) Emergence of drug resistance in HIV type 1-infected patients after receipt of first-line highly active antiretroviral therapy: a systematic review of clinical trials. Clin Infect Dis 47(5):712–722. doi:10.1086/590943

    Article  PubMed  Google Scholar 

  19. Hamkar R, Mohraz M, Lorestani S et al (2010) Assessing subtype and drug-resistance-associated mutations among antiretroviral-treated HIV-infected patients. AIDS 24(suppl 2):S85–S91. doi:10.1097/01.aids.0000386738.32919.67

    Article  PubMed  Google Scholar 

  20. Koigi P, Ngayo MO, Khamadi S, Ngugi C, Nyamache AK (2014) HIV type 1 drug resistance patterns among patients failing first and second line antiretroviral therapy in Nairobi, Kenya. BMC Res Notes 7:890. doi:10.1186/1756-0500-7-890

    Article  PubMed  PubMed Central  Google Scholar 

  21. McFaul K, Lim C, Jones R, Asboe D et al (2014) Transmitted antiretroviral drug resistance in treatment naïve HIV-infected persons in London in 2011 to 2013. J Int AIDS Soc 17(4 Suppl 3):19747. doi:10.7448/IAS.17.4.19747 (e Collection 2014)

    Article  PubMed  PubMed Central  Google Scholar 

  22. Bennett DE, Bertagnolio S, Sutherland D, Gilks CF (2008) The World Health Organization’s global strategy for prevention and assessment of HIV drug resistance. Antivir Ther 13(Suppl 2):1–13

    PubMed  Google Scholar 

Download references

Acknowledgements

The authors would like to thank the Research Consultation Center (RCC) for their invaluable assistance in editing this article. The authors also wish to thank treatment deputy, research deputy of Shiraz University of Medical Sciences, and Mr. Vahapour for invaluable help and support.

Author information

Authors and Affiliations

  1. Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran

    Mohammad Ali Davarpanah & Ehsan Aghah

  2. Treatment Deputy, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran

    Mohammad Ali Davarpanah

  3. Shiraz Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran

    Nasrin Motazedian

  4. Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz, Islamic Republic of Iran

    Hassan Joulaei

  5. Hepatitis and AIDS Department, Pasteur Institute of Iran, Tehran, Iran

    Mohammad Reza Aghasadeghi

  6. Larestan School of Medical Sciences, Larestan, Islamic Republic of Iran

    Hossein Faramarzi

Authors
  1. Mohammad Ali Davarpanah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nasrin Motazedian
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hassan Joulaei
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mohammad Reza Aghasadeghi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Hossein Faramarzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ehsan Aghah
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nasrin Motazedian.

Ethics declarations

Conflict of interest

The Authors declare there is no conflict of interest.

Ethics approval and consent to participate

Our study was approved by the Ethical Committee of Shiraz University of Medical Sciences and informed written consent was taken from all patients. (Committee’s reference number: 59-5056)

Additional information

Handling editor: Li Wu.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Davarpanah, M.A., Motazedian, N., Joulaei, H. et al. Comparison of antiretroviral drug resistance among treatment-naive and treated HIV-infected individuals in Shiraz, Iran. Arch Virol 163, 99–104 (2018). https://doi.org/10.1007/s00705-017-3549-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00705-017-3549-0

Search

Navigation