Molecular epidemiology of HIV-1 strains in the south-east and east of Turkey
Authors: Mustafa Kemal Çelen, Murat Sayan, Tuba Dal, Celal Ayaz, Alicem Tekin, Tuncer O¨ zekinci, Suda Tekin Koruk, Tunga Barcin, Recep Tekin, Mehmet Sinan Dal, Sevgi Kalkanlı
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Objective: To detect the subtype characterization and drug-resistant mutations in HIV-1 strains
after the refugee movement from Syria to Turkey between 2011 and 2014 in south east border lines.
Methods: A total of 65 patients were included in this study, of which 57 (88%) patients were
antiretroviral therapy-naive patients. HIV-1 RNA was detected and quantified by real-time PCR
assay. HIV-1 subtypes and circulating recombinant forms (CRFs) were identified by phylogenetic
analysis (neighbor-joining method), and drug-resistant mutations were analyzed.
Results: Three major HIV groups were indicated. Two of these groups were located in subtype B.
The other group showed heterogeneity. Subtype B (48/65, 73.8%), followed by CRFs (12/65, 18.5%)
was the most common strain. Subtype of CRFs consisted of CRF01_AE (9/65, 13.8%) and
CRF02_AG (3/65, 4.6%). Subtype C (1/65, 1.5%), sub-subtypes A1 (2/65, 3.1%) and F1 (2/65,
3.1%) were also detected with low prevalence. The rate of overall primary antiretroviral resistance
was 4.9% (3/61). Drug-resistant rate for non-nucleoside reverse transcriptase inhibitors was 4.9%.
The thymidine analogue mutation rate was 13.1% (8/61).
Conclusions: HIV molecular epidemiology studies are necessary to determine transmission patterns
and spread. Subtype B and CRF01_AE, CRF02_AG are the most prevalent strains in the south-east of
Turkey. However, subtype C, sub-subtypes A1 and F1 are of low prevalence but persist in the south-east
of Turkey. In the near future, changing of HIV epidemiology will be possible in Turkey due to migration
movement in border lines and resistance testing will play an important role in HIV management.