PLoS ONE (Jan 2013)

Prevalence of transmitted HIV drug resistance in Iran between 2010 and 2011.

  • Fatemeh Jahanbakhsh,
  • Junko Hattori,
  • Masakazu Matsuda,
  • Shiro Ibe,
  • Seyed-Hamid R Monavari,
  • Arash Memarnejadian,
  • Mohammad R Aghasadeghi,
  • Ehsan Mostafavi,
  • Minoo Mohraz,
  • Hossain Jabbari,
  • Kianoush Kamali,
  • Hossein Keyvani,
  • Kayhan Azadmanesh,
  • Wataru Sugiura

DOI
https://doi.org/10.1371/journal.pone.0061864
Journal volume & issue
Vol. 8, no. 4
p. e61864

Abstract

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ObjectiveDrug-resistant (DR) HIV emerges during combined antiretroviral treatment (cART), creating concern about widespread transmission of DR-HIV as cART is expanded in resource-limited countries. The aim of this study was to determine the predominant HIV-1 subtypes and prevalence of transmitted DR mutations among antiretroviral-naïve patients in Iran.DesignTo monitor transmission of DR HIV, a threshold surveillance based on the world health organization (WHO) guidelines was implemented in Iran.MethodsFor this HIVDR threshold surveillance study, blood samples were collected from 50 antiretroviral-naïve HIV-1-infected patients. Antiretroviral-resistant mutations were determined by sequencing HIV-1 protease, reverse transcriptase and integrase regions. The HIV-1 subtype was determined by sequencing the p17 and C2-V5 regions of the gag and env genes, respectively.ResultsPhylogenetic analyses of the sequenced regions revealed that 45 (95.7%) of 47 samples that were successfully obtained were CRF35_AD. The remaining two cases were subtype B (2.1%) and CRF01_AE (2.1%). Consistent results were obtained also from Env and Gag sequences. Regarding prevalence of transmitted DR viruses, two cases were found to harbor reverse transcriptase-inhibitor-resistant mutations (4.3%). In addition, although not in the WHO list for surveillance of transmitted mutations, 13 minor protease-inhibitor-resistant mutations listed in the International AIDS Society-USA panel of drug resistance mutations were found. No DR mutations were detected in the integrase region.ConclusionsOur study clarified that CRF35_AD is the major subtype among HIV-1-infected patients in Iran. According to the WHO categorization method of HIVDR threshold survey, the prevalence of transmitted drug resistant HIV in Iran was estimated as moderate (5-15%).