title: HIV-1 Transmitted Drug Resistance Mutations in Newly Diagnosed Antiretroviral-Naive Patients in Turkey.
abstract: HIV-1 replication is rapid and highly error-prone. Transmission of a drug-resistant HIV-1 strain is possible and occurs within the HIV-1-infected population. In this study, we aimed to determine the prevalence of transmitted drug resistance mutations (TDRMs) in 1,306 newly diagnosed untreated HIV-1-infected patients from 21 cities across six regions of Turkey between 2010 and 2015. TDRMs were identified according to the criteria provided by the World Health Organization's 2009 list of surveillance drug resistance mutations. The HIV-1 TDRM prevalence was 10.1% (133/1,306) in Turkey. Primary drug resistance mutations (K65R, M184V) and thymidine analogue-associated mutations (TAMs) were evaluated together as nucleos(t)ide reverse transcriptase inhibitor (NRTI) mutations. NRTI TDRMs were found in 8.1% (107/1,306) of patients. However, TAMs were divided into three categories and M41L, L210W, and T215Y mutations were found for TAM1 in 97 (7.4%) patients, D67N, K70R, K219E/Q/N/R, T215F, and T215C/D/S mutations were detected for TAM2 in 52 (3.9%) patients, and M41L + K219N and M41L + T215C/D/S mutations were detected for the TAM1 + TAM2 profile in 22 (1.7%) patients, respectively. Nonnucleoside reverse transcriptase inhibitor-associated TDRMs were detected in 3.3% (44/1,306) of patients (L100I, K101E/P, K103N/S, V179F, Y188H/L/M, Y181I/C, and G190A/E/S) and TDRMs to protease inhibitors were detected in 2.3% (30/1,306) of patients (M46L, I50V, I54V, Q58E, L76V, V82A/C/L/T, N83D, I84V, and L90M). In conclusion, long-term and large-scale monitoring of regional levels of HIV-1 TDRMs informs treatment guidelines and provides feedback on the success of HIV-1 prevention and treatment efforts.
authors.affiliation: 1 Faculty of Medicine, Clinical Laboratory, PCR Unit, University of Kocaeli , Kocaeli, Turkey .|2 Research Center of Experimental Health Sciences, University of Near East , Nicosia, Northern Cyprus .
authors.forename: Murat
authors.initials: M
authors.lastname: Sayan
authors.affiliation: 3 Goztepe Educational and Research Hospital, Clinic of Infectious Diseases, Medeniyet University , Istanbul, Turkey .
authors.forename: Fatma
authors.initials: F
authors.lastname: Sargin
authors.affiliation: 4 Faculty of Medicine, Department of Infectious Diseases, University of Akdeniz , Antalya, Turkey .
authors.forename: Dilara
authors.initials: D
authors.lastname: Inan
authors.affiliation: 5 Educational and Research Hospital, Clinic of Infectious Diseases , Sisli Etfal, Istanbul, Turkey .
authors.forename: Dilek Y
authors.initials: DY
authors.lastname: Sevgi
authors.affiliation: 6 Educational and Research Hospital , Clinic of Infectious Diseases, Ankara Numune, Ankara, Turkey .
authors.forename: Aysel K
authors.initials: AK
authors.lastname: Celikbas
authors.affiliation: 7 Educational and Research Hospital, Clinic of Infectious Diseases , Bakırkoy Dr. Sadi Konuk, Istanbul, Turkey .
authors.forename: Kadriye
authors.initials: K
authors.lastname: Yasar
authors.affiliation: 8 Educational and Research Hospital, Department of Infectious Diseases, University of Katip Celebi , İzmir, Turkey .
authors.forename: Figen
authors.initials: F
authors.lastname: Kaptan
authors.affiliation: 9 Faculty of Medicine, Department of Infectious Diseases, University of Pamukkale , Denizli, Turkey .
authors.forename: Selda
authors.initials: S
authors.lastname: Kutlu
authors.affiliation: 10 Faculty of Medicine, Department of Infectious Diseases, University of 19 Mayıs , Samsun, Turkey .
authors.forename: Nuriye T
authors.initials: NT
authors.lastname: Fisgin
authors.affiliation: 11 Educational and Research Hospital, Clinic of Infectious Diseases , Istanbul Kanuni Sultan Süleyman, Istanbul, Turkey .
authors.forename: Ayse
authors.initials: A
authors.lastname: Inci
authors.affiliation: 12 Educational and Research Hospital, Clinic of Infectious Diseases , Haydarpasa Numune, Istanbul, Turkey .
authors.forename: Nurgul
authors.initials: N
authors.lastname: Ceran
authors.affiliation: 13 Faculty of Medicine, Department of Infectious Diseases, University of Gaziantep , Gaziantep, Turkey .
authors.forename: Ilkay
authors.initials: I
authors.lastname: Karaoglan
authors.affiliation: 14 Faculty of Medicine, Department of Infectious Diseases, University of Istanbul , Istanbul, Turkey .
authors.forename: Atahan
authors.initials: A
authors.lastname: Cagatay
authors.affiliation: 15 Faculty of Medicine, Department of Infectious Diseases, University of Dicle , Diyarbakır, Turkey .
authors.forename: Mustafa K
authors.initials: MK
authors.lastname: Celen
authors.affiliation: 16 Faculty of Medicine, Department of Infectious Diseases, University of Harran , Urfa, Turkey .
authors.forename: Suda T
authors.initials: ST
authors.lastname: Koruk
authors.affiliation: 17 Faculty of Medicine, Department of Infectious Diseases, University of Bezm-i Alem , Istanbul, Turkey .
authors.forename: Bahadir
authors.initials: B
authors.lastname: Ceylan
authors.affiliation: 18 Educational and Research Hospital, Clinic of Infectious Diseases , Istanbul Okmeydani, Istanbul, Turkey .
authors.forename: Taner
authors.initials: T
authors.lastname: Yildirmak
authors.affiliation: 19 Faculty of Medicine, Department of Infectious Diseases, University of Uludag , Bursa, Turkey .
authors.forename: Halis
authors.initials: H
authors.lastname: Akalın
authors.affiliation: 20 Faculty of Medicine, Department of Infectious Diseases, University of Marmara , Istanbul, Turkey .
authors.forename: Volkan
authors.initials: V
authors.lastname: Korten
authors.affiliation: 21 Faculty of Medicine, Department of Infectious Diseases, University of Kocaeli , Kocaeli, Turkey .
authors.forename: Ayse
authors.initials: A
authors.lastname: Willke
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use; D018791:CD4 Lymphocyte Count; D024882:Drug Resistance, Viral / Q000235:genetics*; D005260:Female; D015870:Gene Expression; D015658:HIV Infections / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000635:transmission; D016333:HIV Protease / Q000235:genetics* / Q000378:metabolism; D017320:HIV Protease Inhibitors / Q000627:therapeutic use; D054303:HIV Reverse Transcriptase / Q000235:genetics* / Q000378:metabolism; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics* / Q000254:growth & development; D006801:Humans; D008297:Male; D009154:Mutation; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use; D014421:Turkey / Q000453:epidemiology
chemical_list: D019380:Anti-HIV Agents; D017320:HIV Protease Inhibitors; D012367:RNA, Viral; D018894:Reverse Transcriptase Inhibitors; D054303:HIV Reverse Transcriptase; D016333:HIV Protease