title: Integrase Strand Transfer Inhibitors (INSTIs) Resistance Mutations in HIV-1 Infected Turkish Patients.
abstract: Integrase strand transfer inhibitor (INSTI) is a new class of antiretroviral (ARV) drugs designed to block the action of the integrase viral enzyme, which is responsible for insertation of the HIV-1 genome into the host DNA. The aim of this study was to evaluate for the first time INSTI resistance mutations in Turkish patients.
  
  
  
  This study was conducted in Turkey, between April 2013 and April 2015 using 169 HIV-1-infected patients (78 ARV naive patients and 91 ARV-experienced patients). Laboratory and clinical characteristics of ARV naive and ARV-experienced patients were as follows: gender (M/F): 71/7 and 80/11, median age: 38 and 38.4; median CD4(+) T-cell: 236 and 216 cells/mm(3), median HIV-1 RNA: 4.95+E5 and 1.08E+6 copies/ml. Population-based seqeunces of the reverse transcriptase, protease, and integrase domains of the HIV-1 pol gene were used to detect HIV-1 drug resistance mutations.
  
  
  
  INSTI resistance mutations were not found in recently diagnosed HIV-1-infected patients. However, ARV-experienced patients had major resistance mutations associated with raltegravir and elvitegravir; the following results were generated:F121Y, Y143R, Q148R and E157Q (6/91 - 6.6%).
  
  
  
  The prevalence of INSTI resistant mutations in ART-experienced patients suggested that resistance testing must be incorporated as an integral part of HIV management with INSTI therapies.
authors.affiliation: a Faculty of Medicine, Clinical Laboratory, PCR Unit , University of Kocaeli , Kocaeli , Turkey.|b Research Center of Experimental Health Sciences, University of Near East , Nicosia , Northern Cyprus.
authors.forename: M
authors.initials: M
authors.lastname: Sayan
authors.affiliation: c Clinic of Infectious Diseases , Sisli Etfal, Educational and Research Hospital , Istanbul , Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Gündüz
authors.affiliation: d Faculty of Medicine, Department of Infectious Diseases , University of Mersin , Mersin , Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Ersöz
authors.affiliation: e Clinic of Infectious Diseases , Haydarpasa Numune, Educational and Research Hospital , Istanbul , Turkey.
authors.forename: A
authors.initials: A
authors.lastname: İnan
authors.affiliation: f Faculty of Medicine, Department of Infectious Diseases , University of 19 Mayis , Samsun , Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Deveci
authors.affiliation: g Clinic of Infectious Diseases , Samsun Educational and Research Hospital , Samsun , Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Özgür
authors.affiliation: h Clinic of Infectious Diseases , Medeniyet University, Goztepe Educational and Research Hospital , Istanbul , Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Sargın
authors.affiliation: i Clinic of Infectious Diseases , Umraniye Educational and Research Hospital , İstanbul , Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Karagöz
authors.affiliation: j Clinic of Infectious Diseases , Istanbul Kanuni Sultan Süleyman, Educational and Research Hospital , Istanbul , Turkey.
authors.forename: A
authors.initials: A
authors.lastname: İnci
authors.affiliation: k Faculty of Medicine, Department of Infectious Diseases , University of Akdeniz , Antalya , Turkey.
authors.forename: D
authors.initials: D
authors.lastname: İnan
authors.affiliation: l Clinic of Infectious Diseases , Gulhane Military Medical Academy , Istanbul , Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Ülçay
authors.affiliation: m Faculty of Medicine, Department of Infectious Diseases , University of Gaziantep , Gaziantep , Turkey.
authors.forename: I
authors.initials: I
authors.lastname: Karaoğlan
authors.affiliation: n Faculty of Medicine, Department of Infectious Disease , University of Karadeniz Technical , Trabzon , Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Kaya
authors.affiliation: o Faculty of Medicine, Department of Infectious Diseases , University of Pamukkale , Denizli , Turkey.
authors.forename: S S
authors.initials: SS
authors.lastname: Kutlu
authors.affiliation: p Faculty of Medicine, Department of Infectious Diseases , University of Near East , Nicosia , Northern Cyprus.
authors.forename: K
authors.initials: K
authors.lastname: Süer
authors.affiliation: q Faculty of Medicine, Department of Infectious Diseases , University of Istanbul , İstanbul , Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Çağatay
authors.affiliation: r Faculty of Medicine, Department of Infectious Diseases , University of Uludag , Bursa , Turkey.
authors.forename: H
authors.initials: H
authors.lastname: Akalın
mesh_terms: D000328:Adult; D000368:Aged; D019943:Amino Acid Substitution; D018791:CD4 Lymphocyte Count; D003062:Codon; D060085:Coinfection; D024882:Drug Resistance, Viral; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy* / Q000635:transmission / Q000821:virology*; D019428:HIV Integrase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics*; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009154:Mutation; D012367:RNA, Viral; D012307:Risk Factors; D014421:Turkey; D019562:Viral Load; D055815:Young Adult
chemical_list: D003062:Codon; D019428:HIV Integrase Inhibitors; D012367:RNA, Viral
keywords: DNA sequencing; Dolutegravir; Drug resistance; Elvitegravir; HIV-1 integrase; Integrase inhibitors; Raltegravir