Resistance-Associated Mutations in HIV-1 among Patients Failing First-Line Antiretroviral Therapy:

Thirty-five HIV-1 infected patients showing clinical and/or immunological failure to first line antiretroviral therapy (ART) according to WHO criteria were recruited from the ART center of Lok Nayak Hospital, New Delhi to detect the presence of resistance-mutations in reverse transcriptase (RT) and protease (PR) region of pol gene of HIV-1. Plasma viral load (PVL) was estimated. HIV-1 pol gene region encoding complete protease and reverse transcriptase (codons; 1-232 to 1-242) was reverse transcribed, followed by nested PCR. The PCR product was sequenced and analyzed. Plasma samples from 94.3% of patients with PVL >log10 3.0 c/mL could be amplified and analyzed. Virologic failure was detected in 65.7% of patients according to WHO criteria (PVL >log10 4.0). All patients were found to be infected with subtype C. One or more resistance-mutations were observed among 90.9% of study sequences. Nucleoside reverse transcriptase inhibitor (NRTI) resistance mutations were seen among all patients, with M184V and thy...