ANADOLU’DA HIV-1 ENFEKSİYONUNUN MOLEKÜLER EPİDEMİYOLOJİK ANALİZİ VE ANTİRETROVİRAL İLAÇ DİRENÇ PROFİLİNİN İNCELENMESİ

Abstract

The number of individuals infected with Human Immunodeficiency Virus (HIV) is still increasing. The study aimed to determine the resistance rates against protease inhibitors (PI), nucleoside reverse transcriptase inhibitors (NRTI), non-nucleoside reverse transcriptase inhibitors (NNRTI), integrase inhibitors (INSTI), and capsid inhibitor (CAI) in individuals not receiving antiretroviral (ARV) treatment, as well as the distribution of HIV-1 subtypes. The study included 104 HIV-1 infected treatment-naïve individuals between November 17, 2021, and November 30, 2022. The protease, reverse transcriptase, integrase and capsid gene regions were amplified and sequenced using the Sanger sequencing method. It was found that 97 of the 104 individuals included in the study were from 25 different cities, and 7 were imported cases from 5 different countries. Possible transmission routes were determined as 64.42% through men who have sex with men, 30.77% through heterosexual contact, and in 4.81% of cases, the possible transmission route was unknown. Distributions of subtypes was determined as B (55.77%), A (14.42%), B+CRF02_AG (8.65%), B+F (7.69%), CRF02_AG (3.85%), G+CRF02_AG (2.88%), G (1.92%), A+G (1.92%), B+C (0.96%), C (0.96%), F (0.96%). Any mutation associated with resistance to any ARV drug was detected in 14.42% of the study population, resistance mutations were observed at a rate of 1.92% against PI, 4.80% against NRTI, and 7.69% against NNRTI. No resistance mutations against INSTI and CAI were detected. "Lenacapavir" is the most recently FDA-approved drug in the HIV-1 ARV drug group. This study is the first investigation of resistance mutation against CAI in our country. The absence of resistance mutations against CAI suggests that Lenacapavir could be an option for use in Turkey without resistance issues. Due to recent migration movements to our country, there is a possibility of changes in HIV subtypes and resistance rates to ARV drugs. The subtypes and ARV resistance rates detected in our study still show similarities with data published in our country in the past. However, it is important to monitor HIV-1 subtypes and antiretroviral drug resistance closely and continuously.