Naturally Occurring Mutations in HIV-1 Protease Gene Among People Living With HIV

Zahra Hasanshahi; Ava Hashempour; Javad Moayedi; Zahra Musavi; Behzad Rezaei; Behzad Dehghani; Farzane  Ghasabi

doi:10.18502/acta.v61i3.12736

Zahra Hasanshahi Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
Ava Hashempour Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
Javad Moayedi Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
Zahra Musavi Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
Behzad Rezaei Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
Behzad Dehghani Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
Farzane Ghasabi Shiraz HIV/AIDS Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran

DOI: https://doi.org/10.18502/acta.v61i3.12736

Keywords: Human immunodeficiency viruses (HIV); Protease; Drug resistance

Abstract

The emergence of resistance to antiretroviral drugs is the main problem in their long-term efficacy and by considering the wide use of protease inhibitors (PIs), monitoring drug resistance mutations is necessary. Therefore, this study aimed to investigate the PIs drug resistance mutations in Iranian patients as well as subtyping using bioinformatics analysis. Fifteen Iranian patients living with Human Immunodeficiency Virus (HIV) (PLWH) were examined. RNA was used to amplify and sequence the HIV protease gene; also, HIV viral load was determined for all samples. The sequencing results were analyzed by several strong bioinformatics tools to determine the drug-resistance mutations and HIV subtypes. Some polymorphisms in the protease gene were recognized; however, there was no significant rate of major or minor drug resistance mutations in our studied patients. Subtyping analysis revealed the new subtype (D) and the previously reported ones, A and CRF-AD 35, in patients. This study confirmed that the resistance mutations and genetic polymorphisms of the protease region are rare in Iranian-infected patients that can be concluded that prescribing protease inhibitor class in HIV-infected patients is promising in controlling HIV in Iran. In addition, conducting periodic studies to determine the new mutations and the rate of drug resistance to PIs in Iranian individuals highlights the importance of WHO guidelines that recommends monitoring of genotypic-resistance testing and investigation of mutations in HIV-related genes.