Antiretroviral drug resistance mutations among treated and treatment naïve patients in Pakistan: Diversity of HIV-1 pol gene in Pakistan.
Summary of "Antiretroviral drug resistance mutations among treated and treatment naïve patients in Pakistan: Diversity of HIV-1 pol gene in Pakistan."
Background: Pakistan is experiencing a growing HIV epidemic. Antiretroviral drugs (ARV) have been smuggled into the country without prescriptions since the early 1990s, but are now provided free of cost by the government. We assessed the prevalence of HIV-1 drug resistance and subtype distributions. Methods: Blood specimens were collected from HIV-1-infected participants registered in Sindh Province on dry blood spot (DBS) card in 2008. Pol, protease and partial reverse transcriptase regions were sequenced after reverse transcriptase PCR (RT-PCR). HIV-1 subtype was assigned by phylogenetic analysis. Primary drug resistance was analyzed by the Calibrated Population Resistance (CPR) tool using Stanford Surveillance Drug Resistance Mutation (SDRM) major mutation list. Results:Out of 100 blood samples collected, 42 were suitable for testing. Out of 42, 11 were ARV experience and 31 ARV naïve patients. Among them, 24 were injection drug users (IDUs), four immigrants, two hijras (male transvestites), two men who have sex with men (MSM), four prisoners, one female sex workers, two spouses of HIV-infected persons and four from the general population. ARV resistance among naïve patients was 2/31 (6.5%) and 36.4% (4/11) among ARV experienced patients making an overall resistance of 14.2%. HIV-1 was the predominant sub type found in 35/42 (83.3%) followed by CRFG_AD and C 6.5% each respectively. D, C and G were found in one (2.4%) each respectively. Conclusions: A significant proportion of Pakistani HIV patients have drug resistance. Physicians treating patients should consider the magnitude of drug resistance while selecting regimens, and address drug adherence aggressively.
Affiliation
Bridge Consultants Foundation, Karachi, Hong Kong; drsharafshah@yahoo.com.
Journal Details
This article was published in the following journal.
Name: AIDS research and human retroviruses
ISSN: 1931-8405
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/21591988
- DOI: http://dx.doi.org/10.1089/AID.2010.0324
Medical and Biotech [MESH] Definitions
Drug Resistance, Multiple, Fungal
The ability of fungi to resist or to become tolerant to several structurally and functionally distinct drugs simultaneously. This resistance phenotype may be attributed to multiple gene mutations.
Antiretroviral Therapy, Highly Active
Drug regimens, for patients with HIV INFECTIONS, that aggressively suppress HIV replication. The regimens usually involve administration of three or more different drugs including a protease inhibitor.
Drug Therapy, Computer-assisted
Adjunctive computer programs in providing drug treatment to patients.
Drug Resistance
Diminished or failed response of an organism, disease or tissue to the intended effectiveness of a chemical or drug. It should be differentiated from DRUG TOLERANCE which is the progressive diminution of the susceptibility of a human or animal to the effects of a drug, as a result of continued administration.
Thyroid Hormone Resistance Syndrome
An inherited autosomal recessive trait, characterized by peripheral resistance to THYROID HORMONES and the resulting elevation in serum levels of THYROXINE and TRIIODOTHYRONINE. This syndrome is caused by mutations of gene THRB encoding the THYROID HORMONE RECEPTORS BETA in target cells. HYPOTHYROIDISM in these patients is partly overcome by the increased thyroid hormone levels.
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