Abstract
Antiretroviral therapy (ART) has been successful at decreasing the morbidity and mortality associated with human immunodeficiency virus type 1 (HIV-1) infection. HIV-1 drug resistance (HIVDR) among ART-naive patients has been documented to compromise the success of initial therapy. This study was conducted to determine the prevalence of HIVDR mutations among newly diagnosed drug-naive HIV-infected individuals in Lebanon. Plasma samples from 37 newly diagnosed participants at various stages of HIV-1 infection were used to determine HIV-1 RNA viral load, isolate viral RNA, and amplify DNA by RT-PCR. Purified PCR products were used to perform genotypic resistance tests. The prevalence of resistance mutations to nucleoside reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRT), and protease inhibitors (PI) were 5.4%, 10.8%, and 8%, respectively. The major mutations detected in the study participants conferred resistance to NRTIs and NNRTIs recommended for HIV-1 treatment. No significant relationship between HIV-1 viral load of participants and the mode of HIV-1 transmission or between the occurrence of HIVDR and the mode of transmission was found. To our knowledge, this is the first study on HIVDR mutations among newly diagnosed HIV-infected persons in Lebanon. The overall prevalence of HIVDR mutations detected in our study was 16%. Our results are important for evaluating the utility of the standard first-line regimens in use, determining the feasibility of HIVDR testing before the initiation of ART, as well as minimizing the emergence and transmission of HIVDR.
Highlights
Antiretroviral therapy (ART) has been successful at decreasing the morbidity and mortality associated with human immunodeficiency virus type 1 (HIV-1) infection
The participants were infected with the following subtypes: HIV-1A (n = 4, 11%), HIV-1B (n = 12, 32%), HIV-1C (n = 1, 2.7%), CRF02_AG (n = 4, 11%), and 4 patients separately infected with HIV-1F (2.7%), HIV-1G (2.7%), CRF-06cpx (2.7%), and CRF-16AD (2.7%)
HIV-1B subtype was predominant among the study participants
Summary
Antiretroviral therapy (ART) has been successful at decreasing the morbidity and mortality associated with human immunodeficiency virus type 1 (HIV-1) infection. HIV-1 drug resistance (HIVDR) among ART-naive patients has been documented to compromise the success of initial therapy. This study was conducted to determine the prevalence of HIVDR mutations among newly diagnosed drug-naive HIV-infected individuals in Lebanon. The major mutations detected in the study participants conferred resistance to NRTIs and NNRTIs recommended for HIV-1 treatment. The use of antiretroviral therapy (ART) has significantly reduced the mortality and morbidity caused by human immunodeficiency virus type-1 (HIV-1) [1]. By the end of 2011, approximately eight million people living with HIV were receiving antiretroviral therapy in lowand middle-income countries. HIV-1 drug resistance (HIVDR) can be transmitted to ART-naive HIV-infected individuals [6,7]. The International AIDS Society USA guidelines for the use of ART in adults recommend testing for HIVDR prior to initiation of therapy in high-resources countries [8,9]
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