Genotypic resistance mutations in treatment-naive and treatment-experienced patients under widespread use of antiretroviral drugs in Thailand: implications for further epidemiologic surveillance

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  • Sukasem Chonlaphat
    Department of Pathobiology, Faculty of Science, Ramathibodi Hospital, Mahidol University, Thailand Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand
  • Churdboonchart Vina
    Department of Pathobiology, Faculty of Science, Ramathibodi Hospital, Mahidol University, Thailand
  • Sirisidthi Kanjana
    Department of Pathobiology, Faculty of Science, Ramathibodi Hospital, Mahidol University, Thailand
  • Riengrojpitak Suda
    Department of Pathobiology, Faculty of Science, Ramathibodi Hospital, Mahidol University, Thailand
  • Chasombat Sanchai
    HIV Care Unit, The Bureau of AIDS, TB and STIs, Department of Disease Control, Ministry of Public Health, Thailand
  • Watitpun Chotip
    Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand
  • Piroj Wantanich
    Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand
  • Tiensuwan Montip
    Department of Mathematics, Faculty of Science, Ramathibodi Hospital, Mahidol University, Thailand
  • Chantratita Wasun
    Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Thailand

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  • Genotypic Resistance Mutations in Treatment-Naïve and Treatment-Experienced Patients under Widespread Use of Antiretroviral Drugs in Thailand: Implications for Further Epidemiologic Surveillance

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<p>The aims of this study were to illustrate the prevalence and determinants of mutations associated with antiretroviral drug resistance in a group of antiretroviral-naïve and treatment-experienced patients in Thailand, where antiretroviral drugs are widely used. One hundred and thirteen treatment-naïve (92 CRF01_AE and 21 subtype B patients) and 1,709 treatment-experienced patients were recruited. Genotypic resistance to antiretroviral drugs was studied by sequencing the isolated viruses. Mutation frequencies in treatment-naïve patients were reported along with those for treatment-experienced patients. The results showed that all of the patients with treatment experience showed the same pattern of genotypic resistance. The results also showed that only 14 drug-naïve patients (12.4%) carried HIV-1, with at least one drug-resistant mutation. Moreover, four drug-naïve patients were found to carry the marker mutations for transmission of drug resistance. The most commonly found marker in drug-naïve patients was M36I/V/L (n = 90, 81.1%), which is a common natural polymorphism among HIV-1 subtype CRF01_AE individuals. In order to prevent the rapid emergence of resistant virus strains, a national program to monitor antiretroviral drug resistance should be established. We also recommend routine genotypic testing in treatment-naïve patients before starting antiretroviral therapy to prevent subtherapeutic response and viral failure.</p>

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