Transmitted antiretroviral drug resistance mutations in newly diagnosed HIV-1 positive patients in Turkey.
BACKGROUND
The objective of this study was to determine the transmitted drug resistance mutations (TDRMs) in newly diagnosed HIV-1 positive patients in Turkey.


METHODS
The study was carried out between 2009 and 2014 and antiretroviral naïve 774 HIV-1 infected patients from 19 Infectious Diseases and Clinical Microbiology Departments in Turkey were included; gender: 664 (86%) male, median age: 37 (range; 1-77), median CD4+T-cell: 360 (range; 1-1320) count/mm(3), median HIV-RNA load: 2.10+E6 (range; 4.2+E2-7.41+E8) IU/mL. HIV-1 drug resistance mutations were detected by population based sequencing of the reverse transcriptase (codon 41-238) and protease (codon 1-99) domains of pol gene of HIV-1, and analyzed according to the criteria by the World Health Organization 2009 list of surveillance drug resistance mutations [1].


RESULTS
The patients had TDRMs to NRTIs (K65R, M184V), NNRTIs (K101E, K103N/S, G190A/E/S, Y181I/C, Y188H/L) and PIs (M46L, I54V, L76V, V82L/T, N83D, I84V, L90M). The prevalence of overall TDRMs was 6.7% (52/774). Resistance mutations were found to be 0.7% (6/774), 4.1% (32/774) and 2.1% (17/774) to NRTIs, NNRTIs and PIs drug groups, respectively. Three patients had NRTIs+NNRTs resistance mutations (M184V+K103N) as multi-class drug resistance. However, thymidine analogue resistance mutations (TAMs) determined two distinct genotypic profiles in the HIV-1 reverse transcriptase: TAM1: M41L, L210W and T215Y, and TAM2: D67N, K70R, K219E/Q, and T215F. The prevalence of TAM1 and TAM2 were 7.7% (60/774) and 4.3% (34/774), respectively.


CONCLUSIONS
The TDRMs prevalence of antiretroviral naïve HIV-1 infected patients may be suggested current situation of Turkey. These long-term and large-scale results show that the resistance testing must be an integral part of the management of HIV infection in Turkey.
Clinical Laboratory, Kocaeli University, Kocaeli, Turkey.
Murat
M
Sayan
Infectious Diseases, Goztepe Hospital, Medeniyet University, Istanbul, Turkey.
Fatma
F
Sargýn
Infectious Diseases, Akdeniz University, Antalya, Turkey.
Dilara
D
Inan
Infectious Diseases, Sisli Etfal Hospital, Istanbul, Turkey.
Dilek Yýldýz
DY
Sevgi
Infectious Diseases, Ankara Numune Hospital, Ankara, Turkey.
Aysel Kocagül
AK
Celikbas
Infectious Diseases, Bakýrköy Egitim Arastýrma Hospital, Istanbul, Turkey.
Kadriye
K
Yasar
Infectious Diseases, Atatürk Hospital, Katip Celebi University, Izmir, Turkey.
Figen
F
Kaptan
Infectious Diseases, Pamukkale University, Denizli, Turkey.
Selda Sayýn
SS
Kutlu
Infectious Diseases, Mayis University, Samsun, Turkey.
Nuriye Tasdelen
NT
Fýsgýn
Infectious Diseases, Istanbul Kanuni Hospital, Istanbul, Turkey.
Ayse
A
Inci
Infectious Diseases, Haydarpasa Educational and Research Hospital, Istanbul, Turkey.
Nurgül
N
Ceran
Infectious Diseases, Gaziantep University, Gaziantep, Turkey.
Ylkay
Y
Karaoðlan
Infectious Diseases, Istanbul University, Istanbul, Turkey.
Atahan
A
Cagatay
Infectious Diseases, Dicle University, Diyarbakir, Turkey.
Mustafa Kemal
MK
Celen
Infectious Diseases, Harran University, Urfa, Turkey.
Suda Tekin
ST
Koruk
Infectious Diseases, Bezm-i Alem University, Istanbul, Turkey.
Bahadýr
B
Ceylan
Infectious Diseases, Istanbul Okmeydani Hospital, Istanbul, Turkey.
Taner
T
Yýldýrmak
Infectious Diseases, Uludag University, Bursa, Turkey.
Halis
H
Akalýn
Infectious Diseases, Marmara University, Istanbul, Turkey.
Volkan
V
Korten
Infectious Diseases, Kocaeli University, Kocaeli, Turkey.
Ayse
A
Willke