Hiv-1 drug resistance among newly Hiv-1 infected individuals attending tertiary referral center in Chennai, India

Hussain Syed Iqbal, Sunil Solomon, Shanmugam Saravanan, Madhavan Vidya, Nagalingeswaran Kumarasamy, Suniti Solomon, Pachamuthu Balakrishnan

Research output: Contribution to journalArticle

Abstract

Context: In the era of free HAART, accessibility and availability of ARV has been dramatically increased in India. However, rates of treatment literacy and adherence appear to be sub-optimal. Therefore, it is essential to monitor the extent of primary drug resistance in such settings. Materials and Methods: Between July and October 2006, 18 anti-retroviral-nave individuals were identified as recent infected by the BED-Capture enzyme immunoassay in a VCTC clinic in Chennai. Specimens from these individuals were subjected to genotypic drug resistance testing. Phylogenetic trees were generated using MEGA for Windows version 4.0 using neighbor-joining method. The significant differences in polymorphic mutation frequencies between the study specimens and established subtype C-specific polymorphisms were examined using the Chi-square test. Results: Amino acid substitution (K103N and V106MV) at drug resistance positions occurred in two (11%) isolates, conferring high-level resistance to the non-nucleoside reverse-transcriptase inhibitors nevirapine (NVP), efavirenz (EFV), delavirdine (DLV) and notably extensive genetic variations were observed. K122E (94.4%) and K49R/KR (11.1%) polymorphisms identified in this study have not been previously described in established subtype-C specific polymorphisms. The rate of polymorphisms showed marked difference at the locations V60, D121, V35, and D123 (P <0.0001). All the sequences showed maximum homology with Indian HIV-1 subtype C reference strain C.IN.95IN21068. Conclusions: The finding of resistance to NNRTIs is of public health importance. There is an urgent need to establish surveillance for primary drug resistance in large scale. Further studies are required to determine the phenotype impact of newer polymorphic mutations in relation to drug resistance and viral fitness.

Original languageEnglish (US)
Pages (from-to)488-496
Number of pages9
JournalIndian Journal of Medical Sciences
Volume65
Issue number11
DOIs
StatePublished - Nov 1 2011
Externally publishedYes

Fingerprint

Drug Resistance
Tertiary Care Centers
India
efavirenz
Delavirdine
Viral Drug Resistance
Nevirapine
Reverse Transcriptase Inhibitors
Highly Active Antiretroviral Therapy
Mutation Rate
Amino Acid Substitution
Chi-Square Distribution
Immunoenzyme Techniques
HIV-1
Public Health
Phenotype
Mutation
Therapeutics

Keywords

  • HIV-1 polymorphisms
  • Primary HIV-1 drug resistance
  • recent HIV-1 infection

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Hiv-1 drug resistance among newly Hiv-1 infected individuals attending tertiary referral center in Chennai, India. / Iqbal, Hussain Syed; Solomon, Sunil; Saravanan, Shanmugam; Vidya, Madhavan; Kumarasamy, Nagalingeswaran; Solomon, Suniti; Balakrishnan, Pachamuthu.

In: Indian Journal of Medical Sciences, Vol. 65, No. 11, 01.11.2011, p. 488-496.

Research output: Contribution to journalArticle

Iqbal, Hussain Syed ; Solomon, Sunil ; Saravanan, Shanmugam ; Vidya, Madhavan ; Kumarasamy, Nagalingeswaran ; Solomon, Suniti ; Balakrishnan, Pachamuthu. / Hiv-1 drug resistance among newly Hiv-1 infected individuals attending tertiary referral center in Chennai, India. In: Indian Journal of Medical Sciences. 2011 ; Vol. 65, No. 11. pp. 488-496.
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AU - Solomon, Sunil

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AU - Kumarasamy, Nagalingeswaran

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AB - Context: In the era of free HAART, accessibility and availability of ARV has been dramatically increased in India. However, rates of treatment literacy and adherence appear to be sub-optimal. Therefore, it is essential to monitor the extent of primary drug resistance in such settings. Materials and Methods: Between July and October 2006, 18 anti-retroviral-nave individuals were identified as recent infected by the BED-Capture enzyme immunoassay in a VCTC clinic in Chennai. Specimens from these individuals were subjected to genotypic drug resistance testing. Phylogenetic trees were generated using MEGA for Windows version 4.0 using neighbor-joining method. The significant differences in polymorphic mutation frequencies between the study specimens and established subtype C-specific polymorphisms were examined using the Chi-square test. Results: Amino acid substitution (K103N and V106MV) at drug resistance positions occurred in two (11%) isolates, conferring high-level resistance to the non-nucleoside reverse-transcriptase inhibitors nevirapine (NVP), efavirenz (EFV), delavirdine (DLV) and notably extensive genetic variations were observed. K122E (94.4%) and K49R/KR (11.1%) polymorphisms identified in this study have not been previously described in established subtype-C specific polymorphisms. The rate of polymorphisms showed marked difference at the locations V60, D121, V35, and D123 (P <0.0001). All the sequences showed maximum homology with Indian HIV-1 subtype C reference strain C.IN.95IN21068. Conclusions: The finding of resistance to NNRTIs is of public health importance. There is an urgent need to establish surveillance for primary drug resistance in large scale. Further studies are required to determine the phenotype impact of newer polymorphic mutations in relation to drug resistance and viral fitness.

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