Human Immunodeficiency Virus Type-1 Genetic Diversity and Drugs Resistance Mutations among People Living with HIV in Karachi, Pakistan
Rashid A. Kang L. Yi F. Chu Q. Shah S.A. Mahmood S.F. Getaneh Y. Wei M. Chang S. Abidi S.H. Shao Y.
June 2024Multidisciplinary Digital Publishing Institute (MDPI)
Viruses
2024#16Issue 6
The human immunodeficiency virus type-1 epidemic in Pakistan has significantly increased over the last two decades. In Karachi, Pakistan, there is a lack of updated information on the complexity of HIV-1 genetic diversity and the burden of drug resistance mutations (DRMs) that can contribute to ART failure and poor treatment outcomes. This study aimed to determine HIV-1 genetic diversity and identify drug-resistance mutations among people living with HIV in Karachi. A total of 364 HIV-positive individuals, with a median age of 36 years, were enrolled in the study. The HIV-1 partial pol gene was successfully sequenced from 268 individuals. The sequences were used to generate phylogenetic trees to determine clade diversity and also to assess the burden of DRMs. Based on the partial pol sequences, 13 distinct HIV-1 subtypes and recombinant forms were identified. Subtype A1 was the most common clade (40%), followed by CRF02_AG (33.2%). Acquired DRMs were found in 30.6% of the ART-experienced patients, of whom 70.7%, 20.7%, and 8.5% were associated with resistance to NNRTIs, NRTIs, and PIs, respectively. Transmitted DRMs were found in 5.6% of the ART-naïve patients, of whom 93% were associated with resistance against NNRTIs and 7% to PIs. The high prevalence of DRMs in ART-experienced patients poses significant challenges to the long-term benefits and sustainability of the ART program. This study emphasizes the importance of continuous HIV molecular epidemiology and drug resistance surveillance to support evidence-based HIV prevention, precise ART, and targeted AIDS care.
antiretroviral therapy , drug resistance , genetic diversity , HIV-1 , Karachi , Pakistan , phylogeny
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School of Medicine, Nankai University, Tianjin, 300071, China
National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
College of Life Sciences, Nankai University, Tianjin, 300071, China
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310003, China
Bridge Consultants Foundation, Karachi, 75100, Pakistan
Department of Medicine, Aga Khan University, Karachi, 74800, Pakistan
Ethiopian Public Health Institute, P.O. Box 1242, Addis Ababa, Ethiopia
Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, 74800, Pakistan
Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana, 010000, Kazakhstan
Changping Laboratory, Yard 28, Science Park Road, Changping District, Beijing, 102206, China
School of Medicine
National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases
College of Life Sciences
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases
Bridge Consultants Foundation
Department of Medicine
Ethiopian Public Health Institute
Department of Biological and Biomedical Sciences
Department of Biomedical Sciences
Changping Laboratory
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