Drug resistance profile and subtyping of HIV-1 RT gene in Iranian patients under treatment

Identification of drug resistant mutations is important in the management of HIV-1 infected patients. The aim of the current study was to evaluate drug resistance profile of RT gene and assess subtypes among the HIV-1 circulating strains and intensification of physician’s options for the best therapy. HIV-1 RNA of 25 samples was extracted from plasma and RT Nested- PCR was performed and the final products were sequenced and phylogenetically analyzed. Stanford HIV drug resistance sequence database was used for interpretation of the data. The results of phylogenetic analysis showed subtypes A1 and B in 14 (58%) and 10 (42%) patients respectively. Of the 24 patients, 16 (66.6%) had resistance to NRTIs, 8 individuals (32%) to NNRTIs and one patient was susceptible to NRTIs as well as NNRTIs. The drug resistance interpretation in this study showed: 87.7% susceptible for AZT, 70.8% susceptible, and 25% high-level resistance for 3TC, 87.7% susceptible for TDF, 29.1% high-level resistance for NVP and 70.8% susceptible and 25% high- level resistance for EFV. Our data suggests that probably, the use of 2 NRTIs plus 1 protease inhibitor (PI) regimen is more effective than 2 NRTIs plus 1 NNRTI regimen in Iranian patients that use 2 NRTI plus NNRTI regimen and also continuous surveillance should be perform to evaluate resistance patterns for more effective therapeutic approaches.