Study of genotypic resistance mutation to antiretroviral drugs of HIV strains of treatment-naive HIV/AIDS patients in the northeast of China
Objective To study the drug resistance mutations of reverse transcriptase (RT) and protease among HIV-1 strains of treatment-naive HIV/AIDS patients in the northeast of China, provide the base-line data for clinical antiviral treatment in China. Methods We amplified partial pol sequences by RT-PCR and nest-PCR, then sequenced the gene segment. The results compared to the subtype B consensus amino acid sequence Stanford HIV protease sequence database. Results Phylogenetic analysis revealed that 47 of the sequences were classified as subtype B′, 1 as subtype A, 1 as subtype B, and 4 as B′/C recombinant strains according to pol region sequence. No primary mutation associated with protease and RT was detected. Some secondary mutations associated with RT inhibitor were detected: M41L(1.9%), I63M (1.9%), L74I (1.9%), S68G (1.9%), V75L ((3.8%)), V106I (1.9%), I135L/T (5.7%), V179D (7.5%) and V189I (1.9%). In asymptomatic HIV-1 infected individuals, the mean RT related drug resistance mutations were 11.8% strains, while in AIDS patients, the mean RT related drug resistance mutations were 52.6% strains (P0.01). There are many secondary mutations to protease inhibitor (PI): V77I (88.7%), L63P (86.8%), E35D (81%), A71V (24.5%), R41K (15.1%), L10I (9.4%), R57K (9.4%), D60E (9.4%), N37D (5.7%), G16E (3.8%), I15V ((1.9%)), M36I (1.9%), K55R (1.9%) and L89M (1.9%). No mutations specific for a given subtype were noted. Conclusion No major mutations associated with RT and protease of HIV-1 were seen. This study reveals that virus infecting these treatment naive Chinese patients have acquired many secondary mutations in their PR and RT genes, which reminded us to pay more attention to the drug resistance mutations observation and prevention of the prevalence of crossing drug resistance and multi-drug resistance. [