Tuesday, January 5, 2016

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

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.

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1 Faculty of Medicine, Clinical Laboratory, PCR Unit, University of Kocaeli , Kocaeli, Turkey .
2 Research Center of Experimental Health Sciences, University of Near East , Nicosia, Northern Cyprus .
3 Goztepe Educational and Research Hospital, Clinic of Infectious Diseases, Medeniyet University , Istanbul, Turkey .
4 Faculty of Medicine, Department of Infectious Diseases, University of Akdeniz , Antalya, Turkey .
5 Educational and Research Hospital, Clinic of Infectious Diseases , Sisli Etfal, Istanbul, Turkey .
6 Educational and Research Hospital , Clinic of Infectious Diseases, Ankara Numune, Ankara, Turkey .
7 Educational and Research Hospital, Clinic of Infectious Diseases , Bakırkoy Dr. Sadi Konuk, Istanbul, Turkey .
8 Educational and Research Hospital, Department of Infectious Diseases, University of Katip Celebi , İzmir, Turkey .
9 Faculty of Medicine, Department of Infectious Diseases, University of Pamukkale , Denizli, Turkey .
10 Faculty of Medicine, Department of Infectious Diseases, University of 19 Mayıs , Samsun, Turkey .
11 Educational and Research Hospital, Clinic of Infectious Diseases , Istanbul Kanuni Sultan Süleyman, Istanbul, Turkey .
12 Educational and Research Hospital, Clinic of Infectious Diseases , Haydarpasa Numune, Istanbul, Turkey .
13 Faculty of Medicine, Department of Infectious Diseases, University of Gaziantep , Gaziantep, Turkey .
14 Faculty of Medicine, Department of Infectious Diseases, University of Istanbul , Istanbul, Turkey .
15 Faculty of Medicine, Department of Infectious Diseases, University of Dicle , Diyarbakır, Turkey .
16 Faculty of Medicine, Department of Infectious Diseases, University of Harran , Urfa, Turkey .
17 Faculty of Medicine, Department of Infectious Diseases, University of Bezm-i Alem , Istanbul, Turkey .
18 Educational and Research Hospital, Clinic of Infectious Diseases , Istanbul Okmeydani, Istanbul, Turkey .
19 Faculty of Medicine, Department of Infectious Diseases, University of Uludag , Bursa, Turkey .
20 Faculty of Medicine, Department of Infectious Diseases, University of Marmara , Istanbul, Turkey .
21 Faculty of Medicine, Department of Infectious Diseases, University of Kocaeli , Kocaeli, Turkey .
AIDS Res Hum Retroviruses. 2016 Jan;32(1):26-31. doi: 10.1089/AID.2015.0110. Epub 2015 Oct 21.


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