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Context: In the era of free HAART, accessibility and availability of ARV has been dramatically increased in India. However, rates of treatment literacy and adherence appear to be sub-optimal. Therefore, it is essential to monitor the extent of primary drug resistance in such settings. Materials and Methods: Between July and October 2006, 18 anti-retroviral-naive individuals were identified as recent infected by the BED-Capture enzyme immunoassay in a VCTC clinic in Chennai. Specimens from these individuals were subjected to genotypic drug resistance testing. Phylogenetic trees were generated using MEGA for Windows version 4.0 using neighbor-joining method. The significant differences in polymorphic mutation frequencies between the study specimens and established subtype C-specific polymorphisms were examined using the Chi-square test. Results: Amino acid substitution (K103N and V106MV) at drug resistance positions occurred in two (11%) isolates, conferring high-level resistance to the non-nucleoside reverse-transcriptase inhibitors nevirapine (NVP), efavirenz (EFV), delavirdine (DLV) and notably extensive genetic variations were observed. K122E (94.4%) and K49R/KR (11.1%) polymorphisms identified in this study have not been previously described in established subtype-C specific polymorphisms. The rate of polymorphisms showed marked difference at the locations V60, D121, V35, and D123 (P


There is limited [sup][1] or no information available on the transmitted drug resistance among recently HIV-1-infected individuals in India. Transmission of drug resistance viruses results in dissemination and persistence infection by monoclonal or oligoclonal population of resistant viruses, [sup][2] which in turn can be easily transmitted to uninfected individuals, given that the burden of high viral copies in the early phase of infection [sup][3] and the primary drug resistance is a major threat to free rollout programs throughout the world as most of the drugs available via these programs are cross-resistant. In India, among the estimated 2.5 million HIV-1-infected individuals, [sup][4] there are increasing number of individuals being managed on HAART with benefit of 1) drop in anti-retroviral (ARV) drug's cost, [sup][5] 2) introduction of generic ARVs, and 3) Government's free roll-out programs. [sup][6] Even though studies have demonstrated the safety tolerability and effectiveness of generic ARVs, these benefits can be compromised by drug resistance forms, which are contributed by factors like irregularity in adherence and sharing drugs. Along with the burden of drug resistance mutations, the polymorphisms in pol gene of HIV-1 subtypes have significant impact on the clinical management of HIV disease and HIV viral fitness. [sup][7] The study of polymorphic patterns will be useful to estimate their impact in treatment-naive individuals, accordingly, here, we report the primary drug resistance, polymorphic patterns, and clade diversity among recently HIV-1-infected...


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Information on the needs and challenges of patients with TB throughout the period of treatment will be enquired initially. Patients will be asked to free-list the needs they felt during the time of treatment, in terms of resources, information, emotional and spiritual support, instrumental or practical support, and occupational and livelihood support. The level of support reported will be categorised as high, moderate and low. Challenges in terms of stigma and discrimination and barriers faced at health facilities will also be enquired.


The accuracy of the social network data collected from patients is crucial and key to this study. We will be using the following methods and steps to ensure accuracy and reliability.Respondents will be asked to free-list social network members and the type of relationship they have with them. No preconceived relationship categories will be used to question the participant. This validated method will be followed to avoid respondent bias when participants are presented with preconceived relationship categories to fit in their networks.18


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