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Journal of Immune Disorders & Therapy

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Virologic failure on anti-retroviral therapy without HIV drug resistance mutation

Author(s): Dutta N, Omesh S, Nandi S and Saha MK*

BACKGROUND: HIV drug resistance (HIV DR) compromises the antiretroviral therapy (ART) outcome. This study aimed to detect presence of different HIV DR Mutations (DRM) in patients on 2nd line ART failure in Eastern India.

METHODS: HIV/AIDS patients on 2nd line ART were evaluated for virologic failure. HIV-1 genotyping was performed for the virologic failure samples employing Viroseq (Abbott Diagnostics) assay. HIVDR profile and subtype were detected using Stanford HIV sequence database following HIV DRM definition of WHO Surveillance mutation list 2009.

RESULTS: Virologic failure (HIV 1 viral load >1000 copy/ml) was detected among 15 samples out of total 365 HIV/AIDS patients (on 2nd line ART) recruited. Genotyping was successful for 9 samples having >2000 HIV/ml and remaining 6 samples could not be genotyped due to low viral copy. DR mutations were detected in 5 out of 9 samples and among the rest 4 samples no HIV DR mutation was detected. Among NRTI based drugs, M184V and M41L were the predominant mutations (80%). For NNRTI based drugs, A98G and Y181C were predominant (80%), conferring resistance to DLV and NVP. Again for PIs, l54V, A71V, V82A and M46L were seen in 40% of the cases conferring resistance to IDV, SQV, LPV, NFV and ATV.

CONCLUSION: Study on virologic failure in the absence of HIV DR mutations might help in understanding further the HIV DR dynamics as well as planning for better clinical management for patients with HIV/AIDS.

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