Human Immunodeficiency Virus Type 1 Drug Resistance Mutations in Peripheral Blood Mononuclear Cell Proviral DNA among Antiretroviral Treatment-Naive and Treatment-Experienced Patients from Pune, India

Abstract

The prevalence of HIV drug resistance (HIVDR) mutations in the HIV protease (PR) and reverse transcriptase (RT) genes was estimated from peripheral blood mononuclear cells (PBMCs) in a study population of 25 antiretroviral (ARV) therapy-naive and 50 ARV-experienced chronically infected patients from Pune city, Maharashtra State, western India. Of the 75 study HIV-1 sequences, 73 belonged to subtype C and 2 to subtype A1. On phylogenetic analysis, the study subtype C sequences sub clustered randomly with different Indian and non-Indian subtype C sequences, emphasizing the HIV-1 subtype C pol gene diversity. The heterosexual route was the most common route of transmission (74.67%). There were no observable HIVDR mutations in ARV-naive patients. The ARV-experienced patients had a history of exposure to nucleoside reverse transcriptase inhibitor and nonnucleoside reverse transcriptase inhibitor combinations. At least one HIVDR mutation in RT was observed in 29 (80.55%) of ARV-experienced patients with evidence of failing therapy. M184V was the most common observed HIVDR mutation. No PR major mutations were observed among ARV-experienced patients. A higher prevalence of proviral HIVDR mutations in PBMCs was associated with irregular adherence to therapy (p < 0.05) and HIV-1 RNA levels > 1000 copies/ml (p < 0.001).

Drug Resistant Mutations Detected by Genotypic Drug Resistance Testing in Patients Failing Therapy in Clade C Hiv-1 Infected Individuals From India

“…Previous publications from India have highlighted the absence or low prevalence of the Q151M mutation. [4,5] Based on data from the West from previously published studies, M184V was the most commonly observed mutation in patients on NRTIs. [9] We have very limited data but the mutational patterns observed appear similar to published data.…”

“…[9] We have very limited data but the mutational patterns observed appear similar to published data. [4,5,11] One of the worrying factors is a recent report from western India which documented M41L, D67N, M184V, and A98G in the RT gene of treatment naïve individuals. [15] Mutations conferring resistance to NNRTIs were also seen, with one strain showing resistance only to NNRTIs.…”

Short Communication: Analysis of Selection Pressure and Mutational Pattern of HIV Type 1 Reverse Transcriptase Region Among Treated and Nontreated Patients

“…Mutation S48T, observed to be negatively associated with treatment failure, is a common polymorphism that occurred at >50% of drug-naive patients in the present analysis similar to other studies of subtype C viruses. 7,[48][49][50] This finding shows that mutation S48T might be deleterious in terms of viral replication in the presence of resistance mutations, thus increasing the level of the genetic barrier to drug resistance.…”

The integration of water, sanitation and hygiene services into the US President's Emergency Plan for AIDS Relief: A qualitative study

“…Subsequently, malnutrition among PLHIV has been associated with increased mother-to-child transmission, amplified genital shedding of HIV and higher mortality (de Pee & Semba, 2010). Malabsorption of antiretroviral drugs (ARVs) can also occur and lead to drug-resistant HIV strains (Bushen et al, 2004;Sen et al, 2007;USAID, 2012).…”