HIV-1 Drug Resistance Profiles for the HIV Protease and Reverse Transcriptase Gene in Patients Receiving Combination Therapy in Tehran, Iran

Sadeghi, Leila; Lolaie, Masoomeh; Tabatabai, Reza Adl; Bayanolhagh, Saeed; Taj, Leila; Ahmadi, Niloofar Eghbal; Abedinzadeh, Negin; Vakili, Farzaneh; Ahmadi, Ghazaleh; Mohraz, Minoo

doi:10.2174/1871526518666180416110259

Cited by 3 publications

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“…Previous studies from MENA, most of which are from Iran, are largely composed of quantitative surveys, producing lists of risk and protective factors for treatment adherence. [7][8][9][10][11][12][13][14] Our findings suggest that the three key affective and cognitive mechanisms of denial, fear and despair undermine successful and lifelong treatment. We detail the ways in which denial and fear are triggered through a context of negative societal perceptions, lack of awareness regarding HIV and widespread misinformation.…”

Section: Discussionmentioning

confidence: 90%

“…Protected by copyright. BMJ Global Health few studies conducted within MENA, most focus on prevalence or biomedical aspects of the condition, [7][8][9][10] and studies of adherence focus on identifying key affected populations, such as people who use drugs and imprisoned individuals at risk of non-adherence. 11 12 Quantitative and biomedical studies promote understanding about the prevalence and risk profiles of non-adherence among key affected groups, 13 14 and can increase knowledge on drug resistance profiles to antiretroviral therapy in different settings.…”

Section: Key Questionsmentioning

confidence: 99%

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‘You just prefer to die early!’: how socioecological context impedes treatment for people living with HIV in Iran

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IntroductionDespite the low prevalence of HIV and broad provision of antiretroviral therapy, the Middle East and North Africa (MENA) remains the only region where new HIV infections and AIDS-related deaths are not declining. There is a dearth of evidence from MENA on antiretroviral therapy engagement. In this qualitative study, we sought to identify the ways in which successful treatment is hindered in Iran, which is home to 24% of HIV infections in MENA.MethodsFrom August 2018 to January 2019, we used purposive sampling and conducted 12 individual interviews and 8 focus group discussions with 27 female and 31 male patients, in addition to 5 individual interviews with HIV care providers and 1 focus group discussion with 8 care providers. Social constructivism augmented with realist-informed thematic analysis was used to understand how the socioecological context triggers cognitive and affective mechanisms that disrupt antiretroviral therapy.ResultsThe use of Thematic Network Analysis resulted in the identification of three key cognitive and affective mechanisms that appear to shape treatment experience and are triggered via HIV’s socioecological context and changing economic conditions in Iran: denial in response to societal negative perceptions of HIV; fear in response to societal lack of awareness regarding HIV and misinformation; and despair in response to HIV-related stigma and enacted discrimination, economic insecurity and social support.ConclusionsTo our knowledge, this is the first study within MENA to identify pathways through which successful treatment is hindered. It appears that lack of societal awareness regarding HIV is specific to low prevalence settings, such as MENA countries, where negative perceptions, stigma, discrimination and misinformation regarding HIV and its treatment produce denial, fear and despair, acting as mechanisms that disrupt antiretroviral therapy. The experience of despair, in response to changing economic conditions and social support, further impacts treatment experience.

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Section: Discussionmentioning

confidence: 90%

Section: Key Questionsmentioning

confidence: 99%

‘You just prefer to die early!’: how socioecological context impedes treatment for people living with HIV in Iran

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“…These findings are consistent with previous studies demonstrating the high prevalence of drug resistance mutations among HIV-1-positive patients in Iran (25,26). For instance, Sadeghi et al conducted a study where they found that out of 17 patients, 2 (12%) had major PI resistance mutations, while 7 (41%) had minor PI resistance mutations (27). Another study conducted in Iran showed that 32% of patients undergoing antiretroviral treatment had mutations related to PI drug resistance (28).…”

Section: Discussionmentioning

confidence: 99%

Exploring Drug-Resistant Mutations in Protease Inhibitors and Subtype Distribution Among HIV-1 Positive Patients in Lorestan Province, Iran

Talei,

Heydarifard,

Khanizadeh

2024

Jundishapur J Microbiol

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: This study focuses on drug-resistant mutations in protease inhibitors (PIs) and the distribution of Human immunodeficiency virus type 1 (HIV-1) subtypes in Lorestan province, Iran. A total of 59 patients were categorized into two groups: Recipients of antiretroviral therapy (ART) and drug-naive individuals. Genotypic resistance testing was performed using nested PCR, followed by sequencing and analysis of the PCR product to identify drug-resistance mutations and determine the viral subtype. Among the ART recipients, 11 (78%) exhibited major mutations, while 3 (22%) had minor mutations specifically in PIs. The most commonly observed major protease inhibitor (PI) mutations were D30N (27.2%) and V32I (27.2%), followed by G48A (18.1%), L90M (18.1%), and L76V (9%). The most frequent minor PI mutations recorded were K20R (40%), L10I (20%), F53I (20%), and V11I (20%). No drug resistance was detected in drug-naive patients. Lopinavir (LPV) and nelfinavir (NFV) exhibited the highest levels of resistance, while saquinavir (SQV) and fosamprenavir (FPV) showed the highest levels of susceptibility. All participants were found to be infected with CRF35_AD, the dominant HIV-1 subtype in Iran. This study represents the first attempt in the region to analyze drug-resistant mutations in PIs among ART-experienced patients in Lorestan province. The findings contribute to ongoing efforts aimed at controlling the spread of drug-resistant HIV-1 strains.

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The frequency of HIV-1 infection and surveillance drug-resistant mutations determination among Iranians with high-risk behaviors, during 2014 to 2020

Garshasbi¹,

Marjani²,

Alipour³

et al. 2021

IJM

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Background and Objectives: Human immunodeficiency virus (HIV) has various transmission routes. Instant antiretroviral therapy (ART) is the recommended treatment for HIV infection. Highly active antiretroviral therapy (HAART) significantly decreases the acquired immunodeficiency syndrome (AIDS) and AIDS-related co-morbidities. Notwithstanding the suit- ability of HAART, the antiretrovirals (ARVs) have adverse effects and antiretroviral drug resistance mutations are reported among those who receive ARVs. In this survey, the abundance of HIV-1 infection in Iranians with high-risk behaviors, and detection of the surveillance drug-resistant mutations (SDRMs) were evaluated. Materials and Methods: This cross-sectional study was conducted on 250 individuals with high-risk behaviors from Sep- tember 2014 to February 2020. HIV-1 Ag/Ab in plasma samples was detected using enzyme immunoassay (EIA) kits. The conserved region of HIV-1 was detected in the plasma samples by real-time polymerase chain reaction (PCR) assay. Further- more, in individuals with positive HIV-1 RNA, HIV-1 viral load testing was performed. After amplification and sequencing of the HIV-1 protease, reverse transcriptase, and integrase genes, surveillance drug resistance mutation (SDRM) and phylo- genetic analysis were determined. Results: Out of the 250 participants with high-risk behaviors, six (2.4%) were infected with HIV-1. According to the phy- logenetic analysis, the CRF35_AD (83.3% or 5/6) was the dominant subtype, followed by CRF01_AE (16.7% or 1/6). In this research, in none of the HIV-1 infected patients, SDRM for protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), and integrase inhibitors (INs) were observed. Nevertheless, in one of the patients, V179L mutation was detected which is a rare non-polymorphic mutation and is listed as a rilpivirine (RPV) -associated resistance mutation. Conclusion: The results of the current survey revealed that 2.4% of people with high-risk behaviors are infected with HIV and the level of drug resistance mutations (DRMs) in these people is very low.

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HIV-1 Drug Resistance Profiles for the HIV Protease and Reverse Transcriptase Gene in Patients Receiving Combination Therapy in Tehran, Iran

Cited by 3 publications

References 0 publications

‘You just prefer to die early!’: how socioecological context impedes treatment for people living with HIV in Iran

‘You just prefer to die early!’: how socioecological context impedes treatment for people living with HIV in Iran

Exploring Drug-Resistant Mutations in Protease Inhibitors and Subtype Distribution Among HIV-1 Positive Patients in Lorestan Province, Iran

The frequency of HIV-1 infection and surveillance drug-resistant mutations determination among Iranians with high-risk behaviors, during 2014 to 2020

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