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Abstract
Increase in frequency of mutant variants of HIV-1 (subtype-C) carrying drug-resistance related mutations in pol-gene in treatment-naïve patients in North India
S. Arora1, N. Sachdeva2
Background: The HIV infection is going un-abated in developing and under-developed countries due to limited availability of drugs to the infected population because of very high cost. With the gradual decrease in the cost of the anti-retroviral therapy (ART) comprising nucleoside and non-nucleoside reverse transcriptase inhibitors along with protease inhibitors, the treatment is becoming affordable for the HIV/AIDS patients in India and other resource poor countries.
Methods: HIV genome replication being a highly error prone phenomenon, the emergence and transmission of drug-resistant mutants of HIV in the patients is known to be a major cause of treatment failure. Resistance to lamivudine (3-TC) occurs mainly due to point mutations at codon 184 (Met to Val or Ile) in the RT region of HIV whereas resistance to zidovudine (AZT) mainly involves codons 70 (Lys to Arg) & 215 (Thr toPhe). In the present study the pol-gene fragment (768 bp) was first amplified from proviral DNA and mutations were detected by ARMS-PCR using wild and mutant codon-specific primers. The mutations in the pol-gene leading to 3-TC related resistance were screened in 60 treatment naïve & 10 treated patients.
Results: The mutant variants were observed in 20 treatment naïve patients (Met to Val in 4 and Met to
Val as well as Ile in 16 patients) while 2/10 treated patients also showed mutations. For AZT resistance the mutations at codon 215 & 70 was more frequent and could be detected in 15/17 tested cases. CD4/CD8 cell counts by flowcytometry, Plasma HIV-RNA copy numbers by RT-PCR and soluble TNFRII levels were also determined in few cases.
Conclusions: There is an increasing trend in appearance of M184V,I and K70R mutations related to lamivudine and zidovudine resistance respectively, in treatment-naïve individuals in North India. These subjects must be addressed if ART is to play optimal role in blunting and altering the course of HIV pandemic.
AIDS 2006 - XVI International AIDS Conference
Abstract no.
CDB0417
Suggested Citation
"S.Arora, et al.
Increase in frequency of mutant variants of HIV-1 (subtype-C) carrying drug-resistance related mutations in pol-gene in treatment-naïve patients in North India.
:
AIDS 2006 - XVI International AIDS Conference:
Abstract no.
CDB0417"
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