Antiretroviral resistance, genotypic characterization and origin of Human Immunodeficiency Virus among the infected wives of Intravenous drug users in Manipur

Abstract

Increasing incidence of drug resistance is ascertained to be the main obstacles in limiting the virus among the human immunodeficiency virus (HIV) infected individuals. This study investigates the drug resistance mutations (DRMs), genetic variants and origin of transmitted drug resistance of HIV-1 among the HIV-1 infected wives of intravenous drug users (IDUs) in Manipur. 44 HIV pol gene sequences were generated from 56 blood samples by viral gene amplification and sequencing. Sequences were then analysed for drug resistance, genetic variants and origin. The result revealed that among the treatment naive cases, 35.7% had Transmitted Drug Resistance Mutations (TDRMs) while among treatment experienced cases, 50% had Acquired Drug Resistant Mutations (ADRMs). These TDRMs and ADRMs conferred resistance to nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) and/or protease inhibitors (PIs). Majority of the isolated HIV-1 sequences (77.3%) were subtype C while 9.1% was discordant subtype, 6.8% was subtype B, 4.5% was CRF_01AE and 2.3% was URF_BC. TDRM strains were found to be introduced from Myanmar, Vietnam and mainland India. This study also reveals the appearance of CRF_01AE for the first time in Manipur. The finding of this study indicates high prevalence of drug resistant mutations and complex molecular epidemiology in Manipur.

<p>HIV-1 Drug Resistance in ART-Naïve Individuals in Myanmar</p>

“…Myanmar shares border with India, China, Bangladesh, Laos and Thailand. Similar SDRM profiles were also observed among ART-naïve HIV-1 individuals in Thailand, 42 India, 43 and China, 11,37 suggesting a possibility of cross-border transmission of HIV-1 drug resistance. This hypothesis was supported by a previous observation that TDRs circulating in the wives of IDUs in Manipur, India, were introduced from Myanmar, Vietnam and/or mainland India.…”

“…This hypothesis was supported by a previous observation that TDRs circulating in the wives of IDUs in Manipur, India, were introduced from Myanmar, Vietnam and/or mainland India. 43 Our previous studies reported a bidirectional crossborder transmission of HIV-1 between Myanmar and China and demonstrated that Burmese LDTDs and Burmese IDUs staying in Yunnan played a crucial role in this cross-border transmission. 29,30,44 In this study, we identified some transmission clusters formed by HIV-1 drugresistant strains in the China-Myanmar border region.…”

Cocaine sensitizes the CD4+ T cells for HIV infection by co-stimulating NFAT and AP-1

“…These drugs impair individuals’ judgment, which can lead to risky sexual behavior, such as sex trading for drugs and needle sharing. 11 , 12 , 13 , 14 These impairments under the influence of illegal drugs are also a potent cofactor that impedes timely diagnosis of HIV transmission, pathogenesis, and adherence to therapy. 13 , 15 Clinical studies implicate drug abuse in increased viral load, accelerated disease progression, and worsening of AIDS-related mortality even in ART-adherent patients.…”