Abstract
BackgroundThe prices of reverse transcriptase (RT) inhibitors in Thailand have been reduced since December 1, 2001. It is expected that reduction in the price of these inhibitors may influence the drug resistance mutation pattern of HIV-1 among infected people. This study reports the frequency of HIV-1 genetic mutation associated with drug resistance in antiretroviral-treated patients from Thailand.MethodsGenotypic resistance testing was performed on samples collected in 2002 from 88 HIV-1 infected individuals. Automated DNA sequencing was used to genotype the HIV-1 polymerase gene isolated from patients' plasma.ResultsResistance to protease inhibitors, nucleoside and non-nucleoside reverse transcriptase inhibitors were found in 10 (12%), 42 (48%) and 19 (21%) patients, respectively. The most common drug resistance mutations in the protease gene were at codon 82 (8%), 90 (7%) and 54 (6%), whereas resistant mutations at codon 215 (45%), 67 (40%), 41 (38%) and 184 (27%) were commonly found in the RT gene. This finding indicates that genotypic resistance to nucleoside reverse transcriptase inhibitors was prevalent in 2002. The frequency of resistant mutations corresponding to non-nucleoside reverse transcriptase inhibitors was three times higher-, while resistant mutation corresponding to protease inhibitors was two times lower than those frequencies determined in 2001.ConclusionThis study shows that the frequencies of RT inhibitor resistance mutations have been increased after the reduction in the price of RT inhibitors since December 2001. We believe that this was an important factor that influenced the mutation patterns of HIV-1 protease and RT genes in Thailand.
Highlights
The prices of reverse transcriptase (RT) inhibitors in Thailand have been reduced since December 1, 2001
In July 2002, S Sirivichayakul, et al [10] reported genotypic resistant mutations of human immunodeficiency virus type 1 (HIV-1) reverse transcriptase (RT) in HIV-1 infected Thai patients who had been treated with double nucleoside reverse transcriptase inhibitors (NRTIs) for more than eight years
In this report, we show only the frequencies of resistant mutations of HIV-1 isolated from ARVtreated Thai patients, and compare them with the frequencies that were determined in 2001
Summary
The prices of reverse transcriptase (RT) inhibitors in Thailand have been reduced since December 1, 2001. In July 2002, S Sirivichayakul, et al [10] reported genotypic resistant mutations of HIV-1 reverse transcriptase (RT) in HIV-1 infected Thai patients who had been treated with double nucleoside reverse transcriptase inhibitors (NRTIs) for more than eight years. They found 54 (55.7%) out of 97 patients failed to achieve viral suppression. YK Cho, et al (2002) [11] reported the prevalence of HIV-1 drug resistance in South Korea where the AIDS epidemic started at almost the same time that it started in Thailand They found that the viruses from 80% of NRTI-experienced patients had mutations related to AZT resistance while mutations related to 3TC and didanosine (ddI) resistance were found in 11% and 5% of the patients, respectively. No Q151M and NNRTI resistancerelated mutations were found
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