Subtype diversity and emergence of drug resistance in HIV-1 in solapur district of Maharashtra, India

Dilip D. Karad; Ravi Tandon; Ajay Arya; Kailash D. Sonawane; Anusaya S. Chavan; Arun S. Kharat

doi:10.18502/ijm.v14i5.10969

Dilip D. Karad Department of Microbiology, Shri Shivaji Mahavidyalaya, Barshi, India
Ravi Tandon Laboratory of AIDS Research and Immunology, School of Biotechnology, Jawaharlal Nehru University, New Delhi, India
Ajay Arya School of Computational and Integrative Sciences, Jawaharlal Nehru University, New Delhi, India 4Department of Biochemistry, Shivaji University, Kolhapur, India
Kailash D. Sonawane Department of Biochemistry, Shivaji University, Kolhapur, India
Anusaya S. Chavan Department of Chemistry, Dr. Babasaheb Ambedkar Marathwada Univrsity, Aurangabad, India
Arun S. Kharat Laboratory of Applied Microbiology, School of Life Sciences, Jawaharlal Nehru University, New Delhi, India

DOI: https://doi.org/10.18502/ijm.v14i5.10969

Keywords: HIV-1; Antiretroviral therapy; CD4 count; Viral load; Drug resistance

Abstract

Background and Objectives: Even after four decades, HIV infection remains a global challenge and a leading cause of mortality in adults across the world.Anti-retroviral therapy (ART) that controls HIV viremia, is now available through public health facilities in India but drug resistance, which is likely to developamong these individuals remains poorly studied in India. The objectives of present study are to find out the HIV-1 virus subtypes, drug resistance mutationsand HIV-1 drug resistance to NRTI, NNRTI and protease inhibitors in the Solapur district, India.

Materials and Methods: In a cross sectional study, forty two ART-experienced HIV-1-infected patients with CD4+ count < 200 cells ml-1 and viral load (VL) > 3, 000 copies ml-1 were recruited. All patients belonged to Maharashtra State of India near Barshi Solapur and had beenon ART treatment for over 5 years. EDTA whole blood from HIV-1-infected patients was centrifuged and the viral nucleic acid was purified from the plasma.Viral nucleic acid was amplified by PCR using protease and reverse transcriptase specific primers. The resulting amplicons were sequenced and studied formutations. The tools from Stanford University website were used for subtyping of HIV-1 and identification of mutations conferring drug resistance.

Results: Inpresent investigation, HIV-1 subtypes were subtype C in 37 (88.09%), subtype CRF01_AE in 2 (4.76%), and subtype A in 3 patients (7.14%). Drugresistance mutations of NRTI, NNRTI and protease were observed in 15 (37.71%) of 42 patients tested. Drug resistance for NRTI was observed in 12 (28.57%) and for NNRTI in 13 (30.95%) patients. No drug resistance was observed for protease inhibitors.

Conclusion: Considerable HIV-1 drug resistance exists among patients receiving ART from a rural areas of India, suggesting more studies from rural region are required to prevent development of resistance to ART.