HIV‐1 primary drug resistance mutations in antiretroviral therapy‐naïve patients in Istanbul, Turkey

Abstract

According to the official information of Turkish Ministry of Health of HIV/AIDS surveillance data, in the period 1985 to the end of 2011, there are 4826 HIV‐1 infected cases in Turkey. However, there is no data available on the antiretroviral (ART) drug resistance. The objective of this study was to determine primary drug resistance in HIV‐1 infections in newly diagnosed, ART‐naïve Turkish patients in Istanbul, Turkey. The study was carried out between June 2009 and June 2012 and 59 HIV‐1‐infected patients were included (gender; 52 male/7 female, age, median years (range); 37.9 (20–57), CD4+ T‐cell count, median mm3 (range); 280 (3–813), HIV‐RNA load, median IU/ml (range); 4.1 + E5 (2.6 + E3–2.9 + E6)). For HIV‐1 subtyping most widely known algorithm; the HIVdb‐Stanford University genotypic resistance interpretation algorithm has been used. According to population‐based sequencing of the reverse transcriptase and protease genes of HIV‐1, the patients had pre‐existing primary ART drug resistance mutations and were related to NRTIs (M41L, D67N, T215D, T215E, T215S), NNRTIs (V179D) and PIs (I54V, V82A). The prevalence of overall primary ART drug resistance were 11.8% (7/59) in Turkish patients and according to NRTIs, NNRTIs and PIs drug groups were 10% (6/59), 1.7% (1/59) and 1.7% (1/59), respectively (in one patient has been either NRTIs and PIs resistance detected). The high prevalence of HIV‐1 primary drug resistance in ART‐naïve patients suggested the resistance testing must be an integral part of the management of HIV infection and the choice of first‐line therapy regime should be guided by genotypic resistance interpretation in Turkey.