BACKGROUND The therapeutic effect of antiretroviral therapy (ART) is adversely influenced by antiretroviral drug resistance, mainly due to mutations (DRMs) in the human immunodeficiency virus (HIV) genome. These mutations are commonly associated with HIV protease and reverse-transcriptase genes. We sought to determine the frequency of DRMs in a population of ART-experienced patients in the South of Iran. METHOD A total of 44 HIV-1-positive participants under ART were selected from April 2016 to March 2017. Their DRMs, antiretroviral resistance status, and viral subtypes were determined. RESULTS At least one DRM was detected in 61.4% of the participants. The highest frequency was related to nucleotide reverse-transcriptase inhibitor (NRTI) mutations (45.45%). In contrast, major protease inhibitor (PI) mutations had the lowest frequency (6.81%). M184V (40.9%) and K103N (25%), respectively related to NRTI and nonnucleoside reverse-transcriptase inhibitor (NNRTI), were the mutations with the highest frequencies. Susceptibility to PI drugs was higher compared to NRTIs and NNRTIs, which was consistent with the results of genotypic DRMs. CONCLUSION The highest frequency of antiretroviral DRMs was related to NRTIs and NNRTIs. In contrast, PI resistance mutations had the lowest frequency. Laboratory-guided ART to avoid the expansion of mutants as well as investigating DRMs in other viral regions, such as integrase, are recommended.

中文翻译：

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伊朗南部有抗逆转录病毒药物经验的患者中的HIV-1耐药性突变。

背景技术抗逆转录病毒疗法（ART）的治疗效果受到抗逆转录病毒药物耐药性的不利影响，这主要归因于人类免疫缺陷病毒（HIV）基因组中的突变（DRM）。这些突变通常与HIV蛋白酶和逆转录酶基因有关。我们试图确定在伊朗南部经历过抗逆转录病毒治疗的患者中DRM的发生频率。方法从2016年4月至2017年3月，共选择了44名接受ART-1治疗的HIV-1阳性参与者，确定了他们的DRM，抗逆转录病毒耐药状况和病毒亚型。结果在61.4％的参与者中至少检测到一种DRM。最高频率与核苷酸逆转录酶抑制剂（NRTI）突变有关（45.45％）。相反，主要的蛋白酶抑制剂（PI）突变的发生频率最低（6.81％）。分别与NRTI和非核苷逆转录酶抑制剂（NNRTI）相关的M184V（40.9％）和K103N（25％）是频率最高的突变。与NRTI和NNRTI相比，对PI药物的敏感性更高，这与基因型DRM的结果一致。结论抗逆转录病毒药物DRMs的最高频率与NRTIs和NNRTIs有关。相反，PI抗性突变的发生频率最低。建议使用实验室指导的ART，以避免突变体的扩增，并研究其他病毒区域（例如整合酶）中的DRM。这与基因型DRM的结果一致。结论抗逆转录病毒药物DRMs的最高频率与NRTIs和NNRTIs有关。相反，PI抗性突变的发生频率最低。建议使用实验室指导的ART，以避免突变体的扩增，并研究其他病毒区域（例如整合酶）中的DRM。这与基因型DRM的结果一致。结论抗逆转录病毒药物DRMs的最高频率与NRTIs和NNRTIs有关。相反，PI抗性突变的发生频率最低。建议使用实验室指导的ART，以避免突变体的扩增，并研究其他病毒区域（例如整合酶）中的DRM。