Study of HIV-1 Co-receptor Tropism and Resistance to Integrase Strand Transfer Inhibitors in the Indian Patients for Inducting New Antiretroviral Drugs in Treatment Regimens Recipient

The Human Immunodeficiency Virus (HIV) is the causal agent of the Acquired Immunodeficiency Syndrome (AIDS). The Antiretroviral therapy (ART) has been developed to identify effective inhibitors to the replication of this virus, namely viral fusion, reverse transcription and maturation, and thus cope up with the high rates of morbidity and mortality of individuals infected by it. More recently, the HIV-1 integrase and the host CCR5 receptor have become targets for ART. However, as in the case for other drug classes, Integrase Inhibitor Resistance-Associated Mutations (INI- RAMs) and mutations resulting in HIV-1 co-receptor tropism alteration has been reported resulting in the failure of these drugs. The objective of the study was to genetically analyse the RAMs within the integrase gene; and mutations in the V3 loop region of the gp120 of HIV-1 for viral coreceptor tropism alteration of different HIV-1 subtypes in the Indian population and hence evaluate the possibility of using these novel drug classes for effective ART. A total of 56 samples from HIV-1 positive patients were studied. Major INI-RAMs were found in 3.6% of patient samples. In the case of viral tropism study, the prevalence of altered co-receptor tropism was significantly high (14.28% with only X4 and 16.07% with D/M tropism). Therefore, these novel HIV- 1 drug targets viz. Integrase inhibitors and CCR5 antagonists may be included for effective ART regimens in the Indian population after respective molecular analysis.