Aids And Tuberculosis Infection In Hiv-1 Primary Drug Resistance Analysis

Background:Since Highly Active Antiretroviral Therapy(HAART) suggested to apply in clinical on 11th World AIDS Conference in 1996,the treatment was proved in controlling the course of HIV infection, improving the quality of patients'life, and also could decrease the spreading of HIV. However, as HAART was applied for a long period of time, the drug resistance came up.The drug-resistant strains could cause the treatment failure, increase the fatality rate of AIDS patients.It was a serious challenge for the future treatment.Mycobacterium tuberculosis(MTB) infection is the most common opportunistic infection in Chinese AIDS patients.It is also one of the major causes of mortality in AIDS patients.There is a large population of Patients with HIV-1 and tuberculosis co-infection in China. Since it had complex interaction between TB and HIV, and drug interaction between the Antituberculosis drug and the antiviral drug, the treatment timing to start HAART in these co-infection patients is still uncertain for the moment.The data of drug resistance in patients with HIV-1 and TB co-infection was lack. Mutation detection was used to study the status of drug resistance in those patients and to guide the selection of drugs.Methods:Total 38 plasma samples of HIV-1 positive patients were collected from Shanghai Public Health Clinical Center. Virus RNA was extracted by use of TRIzol and QIAGEN Mini Viral kit. The sequence of pol was obtained by reverse transcription and nested PCR and detected by 1% agarose gel electrophoresis.After sequencing was done,the data were obtained by using CLUSTAL X, MEGA 4.0, HIV BLAST and Stata softwares。The sequences were submitted to Stanford HIV Drug Resistance Database (http://hivdb.stanford.edu) to get information about mutations related to HIV-1 drug resistance and resistant level to various drugs.Results:Total of 32 pol gene sequences were obtained from 38 HIV-1 and TB co-infected patients, B,CRF01_AE,CRF07_BC, and C were major genetic subtype, which accounted for 53.1%,37.5%,6.3%,and 3.1%.Respectively,4 PI-resistant strains were found.Mostly in I54F, V32L, L101,andQ58E.1 NRTI-resistant strain was found in L210W.6 NNRTI-resistant strains were found.Mostly in V179D/E, V90I, K103,E138G, and V106I.Conclusion:Results showed there was similar genetic subtype between the HIV-1 single infected patients and patients with HIV-1 and TB co-infection,among whom had higher drug-resistance mutation rate. Therefore, they need drug resistance surveillance before HAART start.