This paper should be cited as: Naziri, H. Tabarraei, A. Ghaemi, A. Davarpanah, M. Javid, A. Moradi, A.

Drug- Resistance- Associated Mutations and HIV Sub-Type Determination in Drug-Naïve and HIV-Positive Patients under Treatment with Antiretroviral Drugs

Naziri, H. (MSc)1, Tabarraei, A. (PhD)2, Ghaemi, A. (PhD)3, Davarpanah, M. (MD)4, Javid, A. (MSc)4, Moradi, A. (PhD)*5

Abstract
Background and Objective: Resistance to antiretroviral agents is a significant concern in clinical management of HIV-infected individuals. Resistance is the result of mutations that develops in the viral protein targeted by antiretroviral agents.

Material and Methods:In this cross-sectional study,the blood samples of 40 HIV-positive patients were collected. Twenty of them were drug-naïve and the rest were under treatment for at least one year by antiretroviral agents. Virus genome was extracted from patient's plasma with high-pure-viral-nucleic-acid kit. Then, by means of reverse-transcriptase and specific primers of protease genes were amplified and sequenced.  Sequences of genes,drug- antiretroviral- resistant mutations and subtypes were determined using Stanford University’s HIV-drug-resistance databases.

Results: Drug-naive patients show 15% resistance to nucleoside-reverse-transcriptase inhibitor (NRTI) and 20% resistance to non-nucleoside-reverse-transcriptase inhibitor (NNRTI). Anti-protease resistance is not observed in any patients. In under treatment patients, drug resistance to NNRTI (25%) is more than drug resistance to NRTI (20%) and the rate of drug resistance to protease inhibitor is 5%.

Conclusion: Our findings show a high prevalence of drug-resistant mutations in Iranian-drug-naïve-HIV-infected patients. But in under treatment individuals, the rate of drug resistance is less than previous studies.

Keywords: HIV; Nucleoside Inhibitor; Non-Nucleoside Inhibitor; Protease Inhibitor

Corresponding Author: Moradi, A.

Email: abmoradi@yahoo.com

Received 16 Nov 2012 Revised 16 Dec 2012 Accepted 18 Dec 2012