HIV-1 Transmitted Drug Resistance Mutations in Newly Diagnosed Antiretroviral-Naive Patients in Turkey

Abstract

HIV-1 replication is rapid and highly error-prone. Transmission of a drug-resistant HIV-1 strain is possible and occurs within the HIV-1-infected population. In this study, we aimed to determine the prevalence of transmitted drug resistance mutations (TDRMs) in 1,306 newly diagnosed untreated HIV-1-infected patients from 21 cities across six regions of Turkey between 2010 and 2015. TDRMs were identified according to the criteria provided by the World Health Organization's 2009 list of surveillance drug resistance mutations. The HIV-1 TDRM prevalence was 10.1% (133/1,306) in Turkey. Primary drug resistance mutations (K65R, M184V) and thymidine analogue-associated mutations (TAMs) were evaluated together as nucleos(t)ide reverse transcriptase inhibitor (NRTI) mutations. NRTI TDRMs were found in 8.1% (107/1,306) of patients. However, TAMs were divided into three categories and M41L, L210W, and T215Y mutations were found for TAM1 in 97 (7.4%) patients, D67N, K70R, K219E/Q/N/R, T215F, and T215C/D/S mutations were detected for TAM2 in 52 (3.9%) patients, and M41L + K219N and M41L + T215C/D/S mutations were detected for the TAM1 + TAM2 profile in 22 (1.7%) patients, respectively. Nonnucleoside reverse transcriptase inhibitor-associated TDRMs were detected in 3.3% (44/1,306) of patients (L100I, K101E/P, K103N/S, V179F, Y188H/L/M, Y181I/C, and G190A/E/S) and TDRMs to protease inhibitors were detected in 2.3% (30/1,306) of patients (M46L, I50V, I54V, Q58E, L76V, V82A/C/L/T, N83D, I84V, and L90M). In conclusion, long-term and large-scale monitoring of regional levels of HIV-1 TDRMs informs treatment guidelines and provides feedback on the success of HIV-1 prevention and treatment efforts.

Integrase Strand Transfer Inhibitors (INSTIs) Resistance Mutations in HIV-1 Infected Turkish Patients

“…Furthermore, this indicates consistency with our previous studies. 12,13 However, there is a high level of heterogeneity in the HIV-1 diversity, specific geographic localization of Turkey may assist in explaining this phenomenon. Extraodinary mass…”

“…11 Only a limited number of studies demonstrate that recently diagnosed HIV-1-infected Turkish patients, also transmitted drug resistance mutation (TDRM); the prevalence range was between 6.2 and 10.1%. 12,13 INSTIs are available to be prescribed in Turkey, although there is no available data on the pre-existing or transmitted INSTI resistance mutations in HIV-1-infected Turkish patients.…”

Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome: Epidemiological Changes in the World and Turkey

“…HIV'ın genetik değişkenliği, enfeksiyonun tanısından başlayıp tedaviye direnç oluşumuna kadar enfeksiyonun yönetimini pek çok aşamada zorlaştırmaktadır. Bulaşmada ve hastalığın progresyonunda HIV alt tipleri arasında farklılıklar olduğu belirtilmektedir (20)(21)(22).…”

“…Özellikle ilaç gruplarında ortaya çıkan direnç oranları ampirik tedaviyi belirlemede önemlidir. Hastaların çevre ülkelerle ilişkili olabildiği bu hastalıkta o ülkelere ait direnç modelleri de zaman zaman dikkat çekici boyutlara ulaşabilmektedir (20,22). HIV enfeksiyonu; multi disipliner yaklaşım, erken tanı, düzenli izlem ve anti retroviral tedavi ile günümüzde yönetilebilir kronik bir enfeksiyondur.…”

Molecular Characterization of Drug Resistance in Hepatitis B Viruses Isolated from Patients with Chronical Infection in Turkey

“…In a single large -scale study, Sayan et al, analyzed 1306 HIV -positive patients and coinfection of HIV/HBV was 2.7%. Sexual contact was reported as the acquisition route in 98.6% of the patients, whereas the use of injection drug was only 0.3% (44). Amiri et al, reported the coinfection of HBV/HIV as 1.8% and concluded that the use of injection drug severely affected the degree of coinfection (45).…”