title: Emergence of drug resistance in human immunodeficiency virus type 1 infected patients from pune, India, at the end of 12 months of first line antiretroviral therapy initiation.
abstract: Introduction. In India, 4,86,173 HIV infected patients are on first line antiretroviral therapy (ART) as of January 2012. HIV drug resistance (HIVDR) is drug and regimen-specific and should be balanced against the benefits of providing a given ART regimen. Material & Methods. The emergence of HIVDR mutations in a cohort of 100 consecutive HIV-1 infected individuals attending ART centre, on first line ART for 12 months, was studied. CD4(+) T-cell counts and plasma HIV-1 RNA level were determined. Result. Out of the 100 HIV-1 infected individuals, 81 showed HIVDR prevention (HIV-1 RNA level < 1000/mL), while the remaining 19 had HIV-1 viral RNA level > 1000/mL. HIVDR genotyping was carried out for individuals with evidence of virologic failure (HIV-1 RNA level > 1000/mL). The most frequent NRTI-associated mutation observed was M184V, while K103N/S was the commonest mutation at NNRTI resistance position. Conclusion. Our study has revealed the emergence of HIVDR in HIV-1 infected patients at the end of 12 months of first line ART initiation. For NRTIs, the prevalence of HIVDR mutations was 9% and 10% for NNRTIs. Our findings will contribute information in evidence-based decision making with reference to first and second line ART delivery and prevention of HIVDR emergence.
authors.affiliation: Department of Microbiology, Azeezia Institute of Medical Sciences & Research, Kollam, Kerala, India.
authors.forename: Rajesh T
authors.initials: RT
authors.lastname: Patil
authors.affiliation: DDGMS (IT) Office of Directorate General of Medical Services (Army) Integrated HQ of MoDAG's Branch, L Block, New Delhi, India.
authors.forename: Rajiv M
authors.initials: RM
authors.lastname: Gupta
authors.affiliation: Department of Microbiology, Army Hospital (Research & Referral), Delhi, India.
authors.forename: Sourav
authors.identifier: 0000-0001-9117-2235
authors.initials: S
authors.lastname: Sen
authors.affiliation: National JALMA Institute of Leprosy and other Mycobacterial Diseases (Indian Council of Medical Research), Agra, India.
authors.forename: Srikanth P
authors.initials: SP
authors.lastname: Tripathy
authors.affiliation: National AIDS Research Institute (Indian Council of Medical Research), Pune, India.
authors.forename: Devidas N
authors.initials: DN
authors.lastname: Chaturbhuj
authors.affiliation: National AIDS Research Institute (Indian Council of Medical Research), Pune, India.
authors.forename: Nitin K
authors.initials: NK
authors.lastname: Hingankar
authors.affiliation: National AIDS Research Institute (Indian Council of Medical Research), Pune, India.
authors.forename: Ramesh S
authors.initials: RS
authors.lastname: Paranjape