Publications by authors named "Abraham Joseph Kandathil"

Current antiretroviral therapies have improved the duration and quality of life of people living with HIV-1. However, viral reservoirs impede complete eradication of the virus. Although there are many strategies to eliminate infectious virus, the most actively pursued are latency reversing agents in conjunction with immune modulation.

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The reverse transcriptase (RT) enzyme is the prime target of nucleoside/ nucleotide (NRTI) and non-nucleoside (NNRTI) reverse transcriptase inhibitors. Here we investigate the structural basis of effects of drug-resistance mutations in clade C RT using three-dimensional structural modeling. Apropos the expectation was for unique mechanisms in clade C based on interactions with amino acids of p66 subunit in RT molecule.

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Article Synopsis
  • The study aimed to analyze the rates and reasons for changing initial antiretroviral treatment (ART) among HIV-infected adults in South India, focusing on predictors of treatment change.
  • In a follow-up of 230 HIV-positive patients over 48 weeks, 39.6% experienced treatment changes due to drug toxicities, largely from certain NRTIs, with lactic acidosis, anemia, and peripheral neuropathy being the most common adverse effects.
  • While the ART regimens showed effectiveness in reducing disease progression and mortality, the high incidence of toxicities highlights the need for safer treatment options as access to ART expands.
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Using computer modeling of three-dimensional structures and structural information available on the crystal structures of HIV-1 protease, we investigated the structural effects of mutations, in treatment-naive and treatment-exposed individuals from India and postulated mechanisms of resistance in clade C variants. A large number of models (14) have been generated by computational mutation of the available crystal structures of drug bound proteases. Localized energy minimization was carried out in and around the sites of mutation in order to optimize the geometry of interactions present.

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Background And Objective: HIV-1 uses co-receptors CCR5 and CXCR4 in addition to CD4 for viral entry into cells. CCR5 is used in the early stages of HIV-1 infection, but viruses that utilize CXCR4 for viral entry emerge in the later stages. This is not common among clade C strains, with previous data from India showing the absence of the emergence of CXCR4-using strains.

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The advent of affordable ART has benefited HIV-infected individuals. Prospective studies have shown that the availability of drug resistance reports for infected individuals has allowed more effective regimens to be prescribed as compared to a control group whose physicians had no access to drug resistance reports. There is a paucity of information on the performance of genotypic algorithms on non-clade B HIV-1 strains, especially clade C.

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Functional genes of HIV-1 like the tat express proteins essential for viral survival and propagation. There are variations reported in levels of Tat transactivation among the different subtypes of HIV-1. This study looked at the amino acid differences in the different regions of Tat protein (exon 1) of subtype B and C strains of HIV-1 and tried to observe a molecular basis for protein function.

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