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ISRN AIDS. 2014 Apr 10;2014:674906. doi: 10.1155/2014/674906. eCollection 2014.

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.

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Department of Microbiology, Azeezia Institute of Medical Sciences & Research, Kollam, Kerala, India.
DDGMS (IT) Office of Directorate General of Medical Services (Army) Integrated HQ of MoDAG's Branch, L Block, New Delhi, India.
Department of Microbiology, Army Hospital (Research & Referral), Delhi, India.
National JALMA Institute of Leprosy and other Mycobacterial Diseases (Indian Council of Medical Research), Agra, India.
National AIDS Research Institute (Indian Council of Medical Research), Pune, India.



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.


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.


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.


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.

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