Antiretroviral drug resistance mutations in naïve and experienced patients in Shiraz, Iran, 2014

Resistance to antiretroviral agents is a significant concern in the clinical management of HIV-infected individuals, particularly in areas of the world where treatment options are limited. In this study, we aimed to identify HIV drug-resistance-associated mutations in 40 drug-naïve patients and 62 patients under antiretroviral therapy (ART) referred to the Shiraz HIV/AIDS Research Center – the first such data available for the south of Iran. HIV reverse transcriptase and protease genes were amplified and sequenced to determine subtypes and antiretroviral- resistance-associated mutations (RAMs). Subtype CRF35-AD recombinant was the most prevalent in all patients (98 of 102, 96 % ), followed by subtype A1, and subtype B (one each, 2 % ). Among the 40 ART-naïve patients, two mutations associated with nucleoside reverse transcriptase inhibitor (NRTI) resistance (two with Y115F and T215I) and three associated with non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance (two with G190S and Y181C, four with V179T) were found. Among ART-experienced patients, four mutations associated with resistance to NRTI, four with NNRTI, and five with protease inhibitors (PI) were found. Twenty patients with high levels of resistance were already on second-line therapy. We document for the first time in this region of Iran high levels of ART resistance to multiple drugs. Our findings call for more vigilant systematic ART resistance surveillance, increased resistance testing, careful management of patients with existing regimens, and strong advocacy for expansion of available drugs in Iran. © 2016, Springer-Verlag Wien

Effect of three months aerobic training on TCF7L2 expression in pancreatic tissue in type 2 diabetes rats induced by streptozotocin- nicotinamide

Background: Although less is known about the molecular mechanisms responsible for its genetic compatibility, regular training is identified as a non-pharmacological treatment for obesity and type-II diabetes. This study aimed to determine the effect of a 3 months aerobic training on pancreatic TCF7L2 expression and glycemic profile in type II diabetic rats. Materials and Methods: In this experimental study, type II diabetes was induced in male Wistar rats (n=16, weight: 220±30 g) by intraperitoneal injection of streptozotocin- nicotinamide. Animals were randomly divided into Exercise (n=8) and Control (n=8) groups. Exercise group, but not Control group, was completed a 3 month aerobic training (3 sessions/week). Forty-eight hours after the last exercise session, the relative expression of pancreatic TCF7L2, fasting glucose and serum insulin were measured in two groups. Results: Compared to Control rats, exercise resulted in a significant decrease in fasting glucose in Exercise group (P=0.001). Serum insulin was increased significantly by aerobic training in Exercise group compared to Control one (P=0.014). However, pancreatic TCF7L2 expression did not change by aerobic training (P=0.876). Conclusion: Based on these data, while we concluded that a long-term aerobic training effectively improves the glycemic profile and insulin concentration of type II diabetic rats, such improvements cannot be attributed to TCF7L2 expression in pancreatic tissue

The First Characterization of HIV-1 Subtypes and Drug Resistance Mutations among Antiretrovirally Treated Patients in Kermanshah, Iran

Background: Insufficient therapy during HIV-1 replication can promote the emergence of drug-resistant strains, reduce the effectiveness of antiretroviral treatment (ART), and increase the likelihood of the onward transmission of drug-resistant viruses. We characterized, for the first time, the prevalence of HIV-1 subtypes and drug resistance mutations in a western region of Iran. Methods: This study was conducted among 122 patients on ART at a major referral center in Kermanshah, Iran. Nested PCR was performed using RT gene-specific primers from the pol gene. Sequencing was followed by amplification and purification of the desired sequence. Subtypes and mutations were determined using the Stanford HIV Drug Resistance Database. Results: Most patients (92.6) had subtype CRF 35-AD; 7.4 had subtype B. In total, 36.1 of the patients had at least 1 mutation associated with resistance RT inhibitors. The greatest rates of high-level resistance were observed for nevirapine (21.3) and efavirenz (19.7). Conclusions: Our results showed a high prevalence of drug resistance mutations in strains isolated from patients on treatment. At our center, we therefore recommend that genotyping be performed. This would allow the physician to prescribe appropriate drugs, reduce treatment costs, and increase the longevity and quality of life of patients. © 2017 S. Karger AG, Base

Antiretroviral drug resistance mutations among HIV treatment failure patients in Tehran, Iran

Background: This study aimed to determine drug resistance mutations in patients with virological failure and find correlation between HIV drug resistance test and viral load. Methods: Blood sample was collected from 51 patients who suspicious treatment failure in the center of Imam Khomeini Hospital, Tehran, Iran in 2015. Viral voluntary counseling and testing load test was done and the patients with viral load above 1000 copies choose for detection of drug resistance mutations by genotyping method (29 patients). Results: The majority of patients (82.75) harbored the HIV subtype CRF 35 A-D. The 86.2 patients compromised at least one resistance mutation. The analysis of reverse transcriptase showed M184V (68.9), T215YISF (44.8), K103N (27.6) and the analysis results of protease revealed G73SC (13.8) and I47VA (6.9). Eventually, the significant correlation between viral load and drug resistance was found. Conclusion: The result of our research stress the significance of recognizing drug resistant on time that prohibits the accumulation of drug resistance mutation and circulates the resistance strain of HIV-1 virus and the importance of national study according to the reliable findings for treatment guidelines. © 2017, Iranian Journal of Public Health. All rights reserved