Exploring Drug-Resistant Mutations in Protease Inhibitors and Subtype Distribution Among HIV-1 Positive Patients in Lorestan Province, Iran

authors:

avatar Gholam Reza Talei ORCID 1 , avatar Zahra Heydarifard ORCID 2 , avatar Sayyad Khanizadeh ORCID 2 , *

Department of Virology, Hepatitis Research Center, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
Department of Virology, Hepatitis Research Center, School of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
Jundishapur Journal of Microbiology: Vol.17, issue 3; e145562
published online: April 28, 2024
article type: Research Article
revised: March 12, 2024
DOI: https://doi.org/10.5812/jjm-145562

how to cite: Talei G R, Heydarifard Z, Khanizadeh S. Exploring Drug-Resistant Mutations in Protease Inhibitors and Subtype Distribution Among HIV-1 Positive Patients in Lorestan Province, Iran. Jundishapur J Microbiol. 2024;17(3):e145562. https://doi.org/10.5812/jjm-145562.

Abstract

Objective: This study focuses on drug-resistant mutations in protease inhibitors and the distribution of HIV-1 subtypes in Lorestan province, Iran. 
Methods: A total of 59 patients were categorized into two groups: ART recipients and drug-naive individuals. Genotypic resistance testing was performed using nested-PCR. Subsequently, the PCR-product was sequenced and analyzed to identify drug resistance mutations and determine the viral subtype. 
Results: Among the ART recipients, 11 (78%) exhibited major mutations, while 3 (22%) had minor mutations specifically in protease inhibitors. The most commonly observed major PI mutations were D30N (27.2%) and V32I (27.2%), followed by G48A (18.1%), L90M (18.1%), and L76V (9%). The most frequent minor PI mutations recorded were K20R (40%), L10I (20%), F53I (20%), and V11I (20%). No drug resistance was detected in the drug-naive patients. Lopinavir (LPV) and nelfinavir (NFV) exhibited the highest levels of resistance, while saquinavir (SQV) and fosamprenavir (FPV) displayed the highest levels of susceptibility. All participants were found to be infected with CRF35_AD, which is the dominant HIV-1 subtype in Iran. 
Conclusion: This study, representing the first attempt in the region, indicates a significance of drug-resistant mutations in protease inhibitors among ART-experienced patients in Lorestan province. The findings contribute to the ongoing efforts aimed at controlling the spread of drug-resistant HIV-1 strains.