Background:
Human immunodeficiency virus-1 infection still remains a global health
threat. While antiretroviral therapy is the primary treatment option, concerns about the emergence
of drug-resistance mutations and treatment failure in HIV-infected patients persist.
Objective:
In this study, we investigated the development of drug resistance in HIV-1-infected individuals
receiving antiretroviral therapy for 6-10 years.
Methods:
In this cross-sectional study, we evaluated 144 people living with HIV-1 who had received
antiretroviral therapy for at least 6 years. Plasma specimens were collected, and the HIV-1
viral load and drug-resistance mutations were assessed using molecular techniques.
Results:
The demographic and epidemiological characteristics of the participants were also analyzed:
Twelve [8.3%) of the studied patients showed a viral load over 1000 copies per/mL, which
indicates the suboptimal response to antiretroviral therapy. Significant correlations were found between
viral load and CD4 count, as well as epidemiological factors, such as vertical transmission,
history of imprisonment, and needle stick injuries. Drug resistance mutations were detected in 10
(83.3%) of patients who failed on antiretroviral therapy, with the most common mutations observed
against nucleoside reverse transcriptase inhibitors (5 (41.7%)) and non-nucleoside reverse
transcriptase inhibitors (9 (75%)). Phylogenetic analysis revealed that 12 patients who failed treatment
were infected with CRF35_AD.
Conclusion:
Our study provides important insights into the characteristics and development of
drug resistance in HIV-1-infected individuals receiving long-term antiretroviral therapy in Iran.
The findings underline the need for regular viral load monitoring, individualized treatment selection,
and targeted interventions to optimize treatment outcomes and prevent the further spread of
drug-resistant strains.