Analysis of RT sequences of subtype C HIV-type 1 isolates from indian patients at failure of a first-line treatment according to clinical and/or immunological WHO guidelines.

The reverse transcriptase (RT) sequences of HIV-1 subtype C isolates from Indian patients at failure (according to WHO clinical or immunological criteria) of a first-line treatment including d4T/AZT-3TC-NVP/EFV were compared to those of HIV-1 isolates from naive patients and analyzed for drug resistance mutations (DRMs), which were interpreted according to ANRS and Stanford algorithms. All viruses were of subtype C. We have observed a decrease of the polymorphism at positions 36 and 214 of RT while D121Y, V179I, and Q217E could be new DRMs.

Pol bootscanning analysis of HIV type 1 can exhibit unexpected recombinations.

In France the recommendation is to sequence the RT gene of HIV-1 isolates prior to initiation of antiretroviral therapy. The data are routinely used for molecular characterization of the viruses yielding the subtype or CRF of the isolates investigated together with the absence or presence of drug resistance mutations. In this study, we performed bootscanning analysis on the whole pol gene, in which in vitro and in vivo intersubtype recombination has been reported to occur frequently.

First observation of HIV type 1 drug resistance mutations in Algeria.

This study demonstrates for the first time HIV-1 resistance mutations to all classes of antiretroviral drugs available in Algeria (NRTIs, NNRTIs, PIs) in treated patients at failure. Moreover, it is shown that mutations to NRTIs and PIs can be observed in untreated patients in this country where there is high HIV-1 diversity.