The frequency of HIV-1 infection and surveillance drug-resistant mutations determination among Iranians with high-risk behaviors, during 2014 to 2020
Background and Objectives: Human immunodeficiency virus (HIV) has various transmission routes. Instant antiretroviral therapy (ART) is the recommended treatment for HIV infection. Highly active antiretroviral therapy (HAART) significantly decreases the acquired immunodeficiency syndrome (AIDS) and AIDS-related co-morbidities. Notwithstanding the suitability of HAART, the antiretrovirals (ARVs) have adverse effects and antiretroviral drug resistance mutations are reported among those who receive ARVs. In this survey, the abundance of HIV-1 infection in Iranians with high-risk behaviors, and detection of the surveillance drug-resistant mutations (SDRMs) were evaluated.
Materials and Methods: This cross-sectional study was conducted on 250 individuals with high-risk behaviors from September 2014 to February 2020. HIV-1 Ag/Ab in plasma samples was detected using enzyme immunoassay (EIA) kits. The conserved region of HIV-1 was detected in the plasma samples by real-time polymerase chain reaction (PCR) assay. Furthermore, in individuals with positive HIV-1 RNA, HIV-1 viral load testing was performed. After ampliﬁcation and sequencing of the HIV-1 protease, reverse transcriptase, and integrase genes, surveillance drug resistance mutation (SDRM) and phylogenetic analysis were determined.
Results: Out of the 250 participants with high-risk behaviors, six (2.4%) were infected with HIV-1. According to the phylogenetic analysis, the CRF35_AD (83.3% or 5/6) was the dominant subtype, followed by CRF01_AE (16.7% or 1/6). In this research, in none of the HIV-1 infected patients, SDRM for protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), and integrase inhibitors (INs) were observed. Nevertheless, in one of the patients, V179L mutation was detected which is a rare non-polymorphic mutation and is listed as a rilpivirine (RPV) -associated resistance mutation.
Conclusion: The results of the current survey revealed that 2.4% of people with high-risk behaviors are infected with HIV and the level of drug resistance mutations (DRMs) in these people is very low.
2. Burgos-Soto J, Ben Farhat J, Alley I, Ojuka P, Mulogo E, Kise-Sete T, et al. HIV epidemic and cascade of care in 12 east African rural fishing communities: results from a population-based survey in Uganda. BMC Public Health 2020;20:970.
3. Anoubissi JD, Gabriel EL, Kengne Nde C, Fokam J, Tseuko DG, Messeh A, et al. Factors associated with risk of HIV-infection among pregnant women in Cameroon: evidence from the 2016 national sentinel surveillance survey of HIV and syphilis. PLoS One 2019;14(4):e0208963.
4. Muessig KE, Cohen MS. Advances in HIV prevention for serodiscordant couples. Curr HIV/AIDS Rep 2014;11:434-446.
5. Siangphoe U, Archer KJ, Nguyen C, Lee KR. Associations of antiretroviral therapy and comorbidities with neurocognitive outcomes in HIV-1-infected patients. AIDS 2020;34:893-902.
6. Menéndez-Arias L. Molecular basis of human immunodeficiency virus type 1 drug resistance: overview and recent developments. Antiviral Res 2013;98:93-120.
7. Riddler SA, Haubrich R, DiRienzo AG, Peeples L, Powderly WG, Klingman KL, et al. Class-sparing regimens for initial treatment of HIV-1 infection. N Engl J Med 2008;358:2095-2106.
8. Santoro MM, Perno CF. HIV-1 genetic variability and clinical implications. ISRN Microbiol 2013;2013:481314.
9. Sungkanuparph S, Oyomopito R, Sirivichayakul S, Sirisanthana T, Li PC, Kantipong P, et al. HIV-1 drug resistance mutations among antiretroviral-naïve HIV-1–infected patients in Asia: results from the TREAT Asia studies to evaluate resistance-monitoring study. Clin Infect Dis 2011;52:1053-1057.
10. Tarasova O, Poroikov V. HIV resistance prediction to reverse transcriptase inhibitors: focus on open data. Molecules 2018;23:956.
11. Granich R, Gupta S, Hersh B, Williams B, Montaner J, Young B, et al. Trends in AIDS deaths, new infections and ART coverage in the top 30 countries with the highest AIDS mortality burden; 1990–2013. PLoS One 2015;10(7):e0131353.
12. Farr AC, Wilson DP. An HIV epidemic is ready to emerge in the Philippines. J Intl AIDS Soc 2010;13:16.
13. Zadeh AO, SeyedAlinaghi S, Hassanzad FF, Hajizadeh M, Mohamadi S, Emamzadeh-Fard S, et al. Prevalence of HIV infection and the correlates among homeless in Tehran, Iran. Asian Pac J Trop Biomed 2014;4:65-68.
14. Jarchi M, Bokharaei-Salim F, Esghaei M, Kiani SJ, Jahanbakhsh F, Monavari SH, et al. The frequency of HIV-1 infection in Iranian children and determination of the transmitted drug resistance in treatment-naive children. Curr HIV Res 2019;17:397-407.
15. Vahabpour R, Bokharaei-Salim F, Kalantari S, Garshasbi S, Monavari SH, Esghaei M, et al. HIV-1 genetic diversity and transmitted drug resistance frequency among Iranian treatment-naive, sexually infected individuals. Arch Virol 2017;162:1477-1485.
16. Bennett DE, Camacho RJ, Otelea D, Kuritzkes DR, Fleury H, Kiuchi M, et al. Drug resistance mutations for surveillance of transmitted HIV-1 drug-resistance: 2009 update. PLoS One 2009;4(3):e4724.
17. Marjani A, Bokharaei-Salim F, Jahanbakhshi F, Monavari SH, Esghaei M, Kalantari S, et al. HIV-1 integrase drug-resistance mutations in Iranian treatment-experienced HIV-1-infected patients. Arch Virol 2020;165:115-125.
18. Farrokhi M, Moallemi S, Baesi K, Ahsani-Nasab S, Gholami M, Sadeghi L, et al. HIV drug resistance and phylogeny profile in naive and antiretroviral-experienced patients in Tehran, Iran. Intervirology 2016;59:131-136.
19. Mayer KH, O'Cleirigh C, Skeer M, Covahey C, Leidolf E, Vanderwarker R, et al. Which HIV-infected men who have sex with men in care are engaging in risky sex and acquiring sexually transmitted infections: findings from a Boston community health centre. Sex Transm Infect 2010;86:66-70.
20. SeyedAlinaghi S, Farhoudi B, Mohraz M, Golsoorat Pahlaviani F, Hosseini M, Farnia M, et al. Prevalence and associated factors of HIV infection among male prisoners in tehran, Iran. Arch Iran Med 2017;20:356-360.
21. Kheirandish P, Seyedalinaghi SA, Hosseini M, Jahani MR, Shirzad H, Foroughi M, et al. Prevalence and correlates of HIV infection among male injection drug users in detention in Tehran, Iran. J Acquir Immune Defic Syndr 2010;53:273-275.
22. Allahqoli L, Fallahi A, Rahmani A, Higgs P. The prevalence of human immunodeficiency virus infection and the perceptions of sexually transmitted infections among homeless women. Nurs Midwifery Stud 2018;7:186-191.
23. Zaharatos GJ, Wainberg MA. Update on rilpivirine: a new potent non-nucleoside reverse transcriptase inhibitor (NNRTI) of HIV replication. Ann Med 2013;45:236-241.
24. Frentz D, Boucher CA, van de Vijver DA. Temporal changes in the epidemiology of transmission of drug-resistant HIV-1 across the world. AIDS Rev 2012;14:17-27.
25. Memarnejadian A, Menbari S, Mansouri SA, Sadeghi L, Vahabpour R, Aghasadeghi MR, et al. Transmitted drug resistance mutations in antiretroviral-naïve injection drug users with chronic HIV-1 infection in Iran. PLoS One 2015;10(5):e0126955.
26. Ghafari S, Memarnejadian A, Samarbaf-zadeh A, Mostafavi E, Makvandi M, Salmanzadeh S, et al. Prevalence of HIV-1 transmitted drug resistance in recently infected, treatment-naïve persons in the southwest of Iran, 2014-2015. Arch Virol 2017;162:2737-2745.
27. Sadeghi L, Lolaie M, Tabatabai RA, Bayanolhagh S, Taj L, Ahmadi NE, et al. HIV-1 drug resistance profiles for the HIV protease and reverse transcriptase gene in patients receiving combination therapy in Tehran, Iran. Infect Disord Drug Targets 2018;18:241-248.
28. Iyidogan P, Anderson KS. Current perspectives on HIV-1 antiretroviral drug resistance. Viruses 2014;6:4095-4139.
29. Wensing AM, Calvez V, Ceccherini-Silberstein F, Charpentier C, Günthard HF, Paredes R, et al. 2019 update of the drug resistance mutations in HIV-1. Top Antivr Med 2019;27:111-121.
30. Clutter DS, Jordan MR, Bertagnolio S, Shafer RW. HIV-1 drug resistance and resistance testing. Infect Genet Evol 2016;46:292-307.
31. Hai-Long H, Jian Z, Ping-Ping Y, Liang C, Xun L, Shan ZZ, et al. Genetic characterization of CRF01_AE full-length human immunodeficiency virus type 1 sequences from Fujian, China. AIDS Res Hum Retroviruses 2007;23:569-574.
32. Chehadeh W, Albaksami O, John SE, Al-Nakib W. Drug resistance-associated mutations in antiretroviral treatment-naive and -experienced patients in Kuwait. Acta Virol 2018;62:259-265.
33. Lunar MM, Lepej SŽ, Tomažič J, Vovko TD, Pečavar B, Turel G, et al. HIV-1 transmitted drug resistance in Slovenia and its impact on predicted treatment effectiveness: 2011–2016 update. PLoS One 2018;13(4):e0196670.
34. Ross LL, Shortino D, Shaefer MS. Changes from 2000 to 2009 in the prevalence of HIV-1 containing drug resistance-associated mutations from antiretroviral therapy-naive, HIV-1-infected patients in the United States. AIDS Res Hum Retroviruses 2018;34:672-679.
35. Etta EM, Mavhandu L, Manhaeve C, McGonigle K, Jackson P, Rekosh D, et al. High level of HIV-1 drug resistance mutations in patients with unsuppressed viral loads in rural northern South Africa. AIDS Res Ther 2017;14:36.
36. Tsai HC, Chen IT, Wu KS, Tseng YT, Sy CL, Chen JK, et al. High rate of HIV-1 drug resistance in treatment failure patients in Taiwan, 2009–2014. Infect Drug Resist 2017;10:343-352.
37. Ferreira ACG, Coelho LE, Grinsztejn E, Jesus CS, Guimarães ML, Veloso VG, et al. Transmitted drug resistance in patients with acute/recent HIV infection in Brazil. Braz J Infect Dis 2017;21:396-401.
38. Farrokhi M, Moallemi S, Shirkoohi R, Golmohammadi R, Ahsani-Nasab S, Sardashti S, et al. Antiretroviral drug resistance mutations among HIV treatment failure patients in Tehran, Iran. Iran J Public Health 2017;46:1256.
39. Golmohammadi R, Baesi K, Moradi A, Farrokhi M, McFarland W, Parsamajd S. The first characterization of HIV-1 subtypes and drug resistance mutations among antiretrovirally treated patients in Kermanshah, Iran. Intervirology 2017;60:33-37.
|Issue||Vol 13 No 6 (2021)|
|Human immunodeficiency virus-1; High-risk; Subtype; Infection; Iran|
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