HIV-1 subtypes and primary antiretroviral resistance mutations in antiretroviral therapy naive HIV-1 infected individuals in Turkey

Jpn J Infect Dis. 2013;66(4):306-11. doi: 10.7883/yoken.66.306.

Abstract

In this study, we determined the subtype distribution and the primary drug-resistant mutations in HIV-1 strains isolated from antiretroviral therapy (ART)-naive patients in Turkey. The study included 117 newly diagnosed HIV-1 positive Turkish patients. HIV-1 subtypes and circulating recombinant forms (CRFs) were identified by phylogenetic analysis (neighbor-joining method), and drug-resistant mutations were analyzed according to the 2009 World Health Organization list of surveillance drug-resistant mutations. Subtype CRFs (CRF 02_AG, CRF 01_AE, CRF 12_BF and CRF 03_AB; 47%, 55/117) and B (33.3%, 39/117) were identified as the most common occurring HIV-1 subtypes in Turkey. The patients had primary antiretroviral resistance mutations to nucleos(t)ide reverse transcriptase (RT) inhibitors (NRTIs) (M41L, T215C, T215D, and K219Q), non-nucleoside RT inhibitors (NNRTIs; K103N), and protease inhibitors (PIs; I47V, G73S). The prevalence of overall primary antiretroviral resistance was 7.6% (9/117) in HIV-1 patients from Turkey and drug-resistant rate for NRTIs, NNRTIs, and PIs were 4.2% (5/117), 1.7% (2/117), and 1.7% (2/117), respectively. In this study, various CRFs of HIV-1 were determined, for the first time, in Turkey. The prevalence of HIV-1 primary drug-resistant mutations in ART-naive patients suggested that resistance testing should be incorporated as an integral part of HIV management, and the choice of a first-line therapy regime should be guided by the results of genotypic resistance in Turkey.

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Child, Preschool
  • Cluster Analysis
  • Drug Resistance, Viral*
  • Female
  • Genotype
  • HIV Infections / epidemiology
  • HIV Infections / virology*
  • HIV-1 / classification*
  • HIV-1 / drug effects
  • HIV-1 / genetics*
  • HIV-1 / isolation & purification
  • Humans
  • Male
  • Middle Aged
  • Molecular Epidemiology
  • Mutation*
  • Phylogeny
  • Prevalence
  • Sequence Analysis, DNA
  • Turkey / epidemiology
  • Young Adult