title: Prevalence of transmitted HIV drug resistance in Iran between 2010 and 2011.
abstract: OBJECTIVE
  Drug-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.
  
  
  METHODS
  To monitor transmission of DR HIV, a threshold surveillance based on the world health organization (WHO) guidelines was implemented in Iran.
  
  
  METHODS
  For 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.
  
  
  RESULTS
  Phylogenetic 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.
  
  
  CONCLUSIONS
  Our 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%).
authors.affiliation: Department of Virology, Tehran University of Medical Science, Tehran, Iran.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Jahanbakhsh
authors.forename: Junko
authors.initials: J
authors.lastname: Hattori
authors.forename: Masakazu
authors.initials: M
authors.lastname: Matsuda
authors.forename: Shiro
authors.initials: S
authors.lastname: Ibe
authors.forename: Seyed-Hamid R
authors.initials: SH
authors.lastname: Monavari
authors.forename: Arash
authors.initials: A
authors.lastname: Memarnejadian
authors.forename: Mohammad R
authors.initials: MR
authors.lastname: Aghasadeghi
authors.forename: Ehsan
authors.initials: E
authors.lastname: Mostafavi
authors.forename: Minoo
authors.initials: M
authors.lastname: Mohraz
authors.forename: Hossain
authors.initials: H
authors.lastname: Jabbari
authors.forename: Kianoush
authors.initials: K
authors.lastname: Kamali
authors.forename: Hossein
authors.initials: H
authors.lastname: Keyvani
authors.forename: Kayhan
authors.initials: K
authors.lastname: Azadmanesh
authors.forename: Wataru
authors.initials: W
authors.lastname: Sugiura
mesh_terms: D000293:Adolescent; D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D024882:Drug Resistance, Viral / Q000187:drug effects / Q000235:genetics; D005260:Female; D015752:Genes, env; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology; D019427:HIV Integrase / Q000145:classification / Q000235:genetics*; D016333:HIV Protease / Q000145:classification / Q000235:genetics*; D054303:HIV Reverse Transcriptase / Q000145:classification / Q000235:genetics*; D015497:HIV-1 / Q000145:classification / Q000187:drug effects / Q000235:genetics*; D006801:Humans; D007492:Iran / Q000453:epidemiology; D008297:Male; D009154:Mutation; D010446:Peptide Fragments / Q000145:classification / Q000235:genetics*; D010802:Phylogeny; D015995:Prevalence; D012189:Retrospective Studies; D017422:Sequence Analysis, DNA; D054299:env Gene Products, Human Immunodeficiency Virus / Q000145:classification / Q000235:genetics*
chemical_list: D019380:Anti-HIV Agents; D010446:Peptide Fragments; D054299:env Gene Products, Human Immunodeficiency Virus; C473991:p17 gag peptide, human immunodeficiency virus; D019427:HIV Integrase; C514824:reverse transcriptase, Human immunodeficiency virus 1; D054303:HIV Reverse Transcriptase; D016333:HIV Protease; C514803:p16 protease, Human immunodeficiency virus 1