Integrase Strand Transfer Inhibitors (INSTIs) Resistance Mutations in HIV-1 Infected Turkish Patients

Figures & data

Table 1 Clinical and laboratory characteristics of the patients studied

Characteristic	Antiretroviral naive	Antiretroviral experienced
Patient, no.	78	91
Gender, M/F (%)	71/7 (91%/9%)	80/11 (88%/12%)
Age, median years (range)	38 (23–61)	38.4 (2.5–66)
CD4^+ T-cell count, median mm^3 (range)	236 (6–626)	216 ( 3–884)
HIV-1 RNA load, median, copies/ml (range)	4.95E+5 (3.06E+2 – 3.33E+6)	1.08E+6 (1.48E+2 – 1.57E+7)
Acquisition route, n (%)
Heterosexual contact	52 (67%)	62 (68%)
MSM	24 (31%)	20 (22%)
Bisexuel contact	2 (2%)	4 (5%)
Blood transfusion	–	2 (2%)
Dental surgery	–	1 (1%)
Vertical transmission	–	2 (2%)
HIV-1 subtip, n (%)
Subtype B	48 (62%)	55 (60)
Non-subtype B	20 (26%)	17 (19)
A1	11 (14%)	5 (6%)
C	2 (3%)	3 (3%)
D	1 (1%)	1 (1%)
F1	5 (7%)	6 (7%)
G	1 (1%)	2 (2%)
Circulating recombinant form CRF01_AE	10 (13%)	19 (21%)
CRF02_AG	4 (5%)	12 (13%)
CRF03_AB	4 (5%)	4 (5%)
CRF07_BC	–	1 (1%)
CRF06_cpx	–	1 (1%)
CRF13_cpx	2 (3%)	–
	–	1 (1%)
Coinfection status, n (%)
Hepatitis B	3 (4%)	1 (1%)
Hepatitis C	–	4 (4%)
Hepatitis D	1 (1%)	–
P.jirovecii pneumonia	1 (1%)	2 (2%)
Oral candidiasis	2 (3%)	3 (3%)
Pulmoner tuberculosis	1 (1%)	6 (7%)
CMV infection	–	1 (1%)
Cerebral toxoplasmosis	1 (1%)	2 (2%)
Treatment status, n (%)
	–	Lopinavir/r combination; 38 (42%)
		Efavirenz combination; 31 (34%)
		Lamivudin + zidovudin comb; 17 (19%)
		Prezista/r combination; 2 (2%)
		Raltegravir combination; 2 (2%)
		Abacavir combination; 1 (1%)

Table 2 Integrase strand transfer inhibitors (INSTIs) resistance analysis in Turkish patients infected with HIV-1

Drug class	Resistance mutation pattern
	Antiretroviral naïve, (n = 78)	n	%	Antiretroviral experienced, (n = 91)	n	%
INI	–	–	–	INSTI – naive, (n = 89)
				F121Y, Q148R, E157Q	4	4.4
				INSTI – experienced, (n = 2)
				Y143R, E157Q	2	2.2
				Total	6	6.6

Table 3 Resistance mutation patterns on the revers transcriptase and protease domains of HIV-1 in the patients studied

Drug class	Drug resistance mutation pattern
	Treatment naive (n = 78)	n (%)	Antiretroviral experienced (n = 91)	n (%)
NRTI	M184V	1 (1.2)	K65R, M184V ± TAM1, TAM2 or TAM1 + TAM2	39 (43)
NNRTI	K103N	2 (2.5)	L100I, K101E, K103N/S, V106A/M, Y188L, Y181C, G190A/S	46 (51)
PI	M46L	2 (2.5)	L24I, M46I, I54V, L76V, V82A/T, N83D, N88D, L90M	12 (13)
Total		4 (5)*		56 (62)

NRTI; nucleoside revers transcriptase inhibitors, NNRTI; non- nucleoside revers transcriptase inhibitors, PI; protease inhibitors, ARV; antiretroviral, TAM; thymidine analogue - associated mutation, TAM1; M41L, L210W, T215Y, TAM2; D67N, K70R, K219E/Q/N/R, T215F, T215C/D/S, TAM1 + TAM2; M41L + K219N, M41L + T215C/D/S.

* One patient had M184V + K103N patterns.