Assessing subtypes and drug resistance mutations among HIV-1 infected children who failed antiretroviral therapy in Kelantan, Malaysia

Abstract

A b s t r A c t Antiretroviral (ArV) therapy has dramatically reduced morbidity and mortality in human immunodeficiency virus 1 (HiV-1) infected children. However, development of ArV resistance in these children is a major public health problem due to lack of availability of and access to new drugs. this study was conducted in order to identify circulating HiV subtypes and recombinant forms and evaluate the drug resistance mutation patterns in 18 HiV-1 infected children failing ArV treatment in Kelantan, Malaysia. Genotyping for codon 1-99 of protease (Pr) and 1-250 of reverse transcriptase (rt) were performed by polymerase chain reaction (Pcr) amplification and DnA sequencing. subsequently, these were phylogenetically analyzed to determine the subtypes. crf33_01b (44.4%) was found to be the predominant HiV subtype, followed by b (27.8%), crf15_01b (16.7%) and crf01_AE (11.1%) subtypes. the most prevalent rt mutations were t215f/ V/Y (66.7%), D67G/n (55.6%), K219Q/E/r (44.4%), M184V/i (38.9%), K70r/E (27.8%) and M41L (27.8%), associated with nucleoside reverse transcriptase inhibitors (nrti) resistance; and K103n (55.6%), G190A (33.3%), and K101P/E/H (27.8%) associated with non-nucleoside reverse transcriptase inhibitors (nnrti) resistance. the results showed a possible emergence of crf33_01b as current predominant subtypes/circulating recombinant forms (crfs), and a high frequency of primary mutations among HiV-1 infected children after failure of ArV therapy in Kelantan, Malaysia.

High Rates of Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Human Immunodeficiency Virus Infections and Uncommon HBV Genotype/Subtype and HCV Subtype Distributions among Transgender Individuals in Surabaya, Indonesia

“…The prevalence of HIV in our study is remarkable because it exceeds the high (12z) prevalence of HIV among female sex workers in Surabaya (6). The genomic fragment of CRF01_AE has been identified as the predominant HIV-1 subtype in South East Asia, including Malaysia, Thailand, and Taiwan (43)(44)(45) as well as Jakarta, Surabaya, and Bali in Indonesia (6,46). Our results are consistent with those of previous findings.…”

Antiretroviral drug resistance and HIV-1 subtypes among treatment-naive prisoners in Kelantan, Malaysia

“…However, in 2007, a rapid expansion of CRF33_01B in Kuala Lumpur was observed, suggesting a possible replacement of predominant subtypes in near future [17]. Interestingly, in 2012, Mohamad et al (2012) [8] reported that 44.4% of pediatric patients harboured subtype CRF33_01B. The following year, CRF33_01B was found to be highly prevalent among drug users (71%) [18].…”

“…Viral RNA extraction, reverse transcriptase-PCR (RT-PCR), and nested PCR were performed as previously described [8]. Nucleotide sequences of PR and RT regions were edited, aligned, and analyzed for drug resistance using the Stanford HIV Resistance Database (http://hivdb.stanford.edu/).…”

HIV-1 reverse transcriptase and protease mutations for drug-resistance detection among treatment-experienced and naïve HIV-infected individuals

“…When accompanied by other TAMs, it leads to reduced susceptibility to Abacavir (ABC), Didanosine (DDI), and Tenofovir (TDF). D67E is a non-polymorphic mutation that generally occurs in viruses with multiple TAMs [16,17].…”