The Association Between Genetic Variants in ACE1and ACE2 Genes with Susceptibility to COVID-19 Infection.

Angiotensin-converting enzyme 2 (ACE2) receptors facilitate the entry of the causative virus severe acute respiratory syndrome coronavirus 2 (SARS­CoV­2) into target cells. Some ACE gene variants have been suggested to be involved in COVID-19 pathogenesis. So, the aim was to assess the association between ACE1 rs4646994 and ACE2 rs2285666 genes polymorphisms and the susceptibility and severity of COVID-19. This case-control study was conducted on 197 patients with COVID-19 and 197 healthy controls. ACE-1 insertion/deletion (I/D) (rs4646994) and ACE2 rs2285666 genes polymorphisms were determined by the amplification refractory mutation system- polymerase chain reaction (ARMS-PCR) technique. The DD genotype of ACE1 I/D polymorphism was associated with increased susceptibility to COVID-19 infection (p = 0.012), whereas the ID genotype of this polymorphism was associated with decreased susceptibility (p = 0.003) (significance level = 0.017). There was no significant association in allele and genotype distribution of ACE2 rs2285666 polymorphism between cases and controls. The ACE1 I/D polymorphism may be considered as a risk factor for COVID-19 susceptibility.

Targeting host calcium channels and viroporins: a promising strategy for SARS-CoV-2 therapy.

Despite passing the pandemic phase of the COVID-19, researchers are still investigating various drugs. Previous evidence suggests that blocking the calcium channels may be a suitable treatment option. Ca2+ is required to enhance the fusion process of Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Also, some important inflammatory factors during SARS-CoV-2 infection are dependent on Ca2+ level. On the other hand, viroporins have emerged as attractive targets for antiviral therapy due to their essential role in viral replication and pathogenesis. By inhibiting the host calcium channels and viroporins, it is possible to limit the spread of infection. Therefore, calcium channel blockers (CCBs) and drugs targeting Viroporins can be considered an effective option in the fight against SARS-CoV-2.

Implementation of an In-House Platform for Rapid Screening of SARS-CoV-2 Genome Variations.

BACKGROUND: Global real-time monitoring of SARS-CoV-2 variants is crucial to controlling the COVID-19 outbreak. The purpose of this study was to set up a Sanger-based platform for massive SARS-CoV-2 variant tracking in laboratories in low-resource settings. METHODS: We used nested RT-PCR assay, Sanger sequencing and lineage assignment for 930-bp of the SARS-CoV-2 spike gene, which harbors specific variants of concern (VOCs) mutations. We set up our platform by comparing its results with whole genome sequencing (WGS) data on 137 SARS-CoV-2 positive samples. Then, we applied it on 1028 samples from March-September 2021. RESULTS: In total, 125 out of 137 samples showed 91.24% concordance in mutation detection. In lineage assignment, 123 out of 137 samples demonstrated 89.78% concordance, 65 of which were assigned as VOCs and showed 100% concordance. Of 1028 samples screened by our in-house method, 78 distinct mutations were detected. The most common mutations were: S:D614G (21.91%), S:P681R (12.19%), S:L452R (12.15%), S:T478K (12.15%), S:N501Y (8.91%), S:A570D (8.89%), S:P681H (8.89%), S:T716I (8.74%), S:L699I (3.50%) and S:S477N (0.28%). Of 1028 samples, 980 were attributed as VOCs, which include the Delta (B.1.617.2) and Alpha (B.1.1.7) variants. CONCLUSION: Our proposed in-house Sanger-based assay for SARS-CoV-2 lineage assignment is an accessible strategy in countries with poor infrastructure facilities. It can be applied in the rapid tracking of SARS-CoV-2 VOCs in the SARS-CoV-2 pandemic.

Effective bioremediation of petroleum-contaminated saline soil using halotolerant Bacillus strains isolated from the Persian Gulf.

A consortium isolated from the Persian Gulf is evaluated for its ability to bioremediate petroleum-contaminated soils. The soil sample was collected from oil fields of South Western Iran. The crude oil concentrations were set to 1000-10,000 mg/kg, and the sodium chloride concentration was set to 0.5%, 1%, 1.5%, 2%, and 2.5%. Operational parameters including volume (2-20 ml) and soil moisture (25%, 50%, and 100%) were studied consecutively according to one factor at the time of experimental design. A total number of eight different isolates capable of degrading crude oil were isolated from hydrocarbon-contaminated sites (KL1-KL8). The removal efficiency of Total petroleom hydrocarbons (TPH) with an initial concentration of 1000 mg/kg for numbers of bacterial cells per gram soil of 2, 10, and 20 CFU/g was 20.9%, 45%, and 60%, respectively. The removal efficiency of TPHs (initial concentration of 1000 mg/kg) at the end of fifth week for salinity amounts of 0.5%, 1%, 1.5%, 2%, and 2.5% was 10.87%, 22.4%, 25.7%, 68.6%, and 60.5%, respectively. The TPHs biodegradation efficiencies at different soil/water ratios of 25%, 50%, and 100% (slurry) were 12%, 28.7%, and 60.8%, respectively. In sunflowers, there was no statistically significant difference in seed germination for different levels of soil pollution (p > 0.05). The results of the current work suggest that this process is a viable and efficient method for remediating contaminated sites. To enhance the removal results in real soil, a scale-up study should also be conducted.

Angiotensin-converting enzyme 1 and voltage-gated potassium channel-interacting protein 4 gene polymorphisms in COVID-19 patients from east of Iran.

BACKGROUND: Coronavirus disease 2019(COVID-19), the infectious respiratory disease caused by a newly discovered pathogen (severe acute respiratory syndrome coronavirus 2), is a pandemic that places a burden on the health care system. Recently, most research on COVID-19 has emphasized its profound impact on specific regions and ethnic groups. A possible explanation for these variations in disease presentation and severity might be differences in the gene pool of populations. This study therefore attempted to clarify possible involvements of genetic factors affecting COVID-19 pathogenesis with a focus on voltage-gated potassium channel-interacting protein 4 (KCNIP4) and angiotensin-converting enzyme 1 (ACE1) gene polymorphisms. MATERIALS AND METHODS: In this case-control study, the polymorphisms were genotyped using PCR in 194 COVID-19 patients and 194 healthy controls. RESULTS: COVID-19 susceptibility and severity appeared to be unaffected by these polymorphisms. However, this study supported the relevance of ACE1 II genotype frequency to a decreased number of deaths due to the infection. We found that COVID-19 patients with the ACE1 II genotype have a statistically significant better chance of survival (p = 0.008). CONCLUSION: This study strengthens the idea that the ACE1 I/D polymorphism can be a novel prognostic factor indicating the outcome of COVID-19.

Investigation of frequency and typing of human papillomavirus among genital warts using a reverse dot blot hybridization approach.

BACKGROUND: Human papillomavirus (HPV) is the most common sexually transmitted infection worldwide, affecting about 80% of women up to the age of 50. The persistent infection of high risk-HPV types (HR-HPV) is the leading cause of cervical cancer, the fourth most common cancer of women. Therefore, we aimed to evaluate the frequency and typing of HPV in the genital lesions in the Iranian population. METHODS: This descriptive-analytic study was conducted on a population in the South-Khorasan province of Iran. All of the participants were sexually active and were checked for evident cervical warts. Biopsy samples were collected from various lesions, and all samples were tested for detection and genotyping of HPV using a reverse dot blot hybridization method (HPV direct flow CHIP). RESULTS: In overall, 370 samples were evaluated; 10 cases (2.7%) were male and the rest were female. The mean age of patients was 33.3 ± 8.5 years, of which 48.1% were in the age range from 25 to 36 years. Among the samples, 345 (93.2%) were positive for HPV-DNA; the low risk HPV types (LR-HPV) and HR-HPV were identified among 80.9% and 15.5% of tissue samples, respectively. Among the LR-HPV, HPV-6, 11, 42 and 54 were the most common genotypes, and HPV-16 and 39 were prevalent HR-HPV types detected. The number of pregnancies, marriage age, and partner infection were not significantly related to the HPV types. Types 42 had a declining pattern toward aging, and HPV-11 was increasing toward aging. CONCLUSION: The number of samples with HR-HPV was rather high. Due to the greater frequency of infection in the age range of 25-35 years, it is advised that all individuals referred to gynecological clinics at gestational age be tested for HPV types.

Repurposing the drug, ivermectin, in COVID-19: toxicological points of view.

The global COVID-19 pandemic has affected the world's population by causing changes in behavior, such as social distancing, masking, restricting people's movement, and evaluating existing medication as potential therapies. Many pre-existing medications such as tocilizumab, ivermectin, colchicine, interferon, and steroids have been evaluated for being repurposed to use for the treatment of COVID-19. None of these agents have been effective except for steroids and, to a lesser degree, tocilizumab. Ivermectin has been one of the suggested repurposed medications which exhibit an in vitro inhibitory activity on SARS-CoV-2 replication. The most recommended dose of ivermectin for the treatment of COVID-19 is 150-200 µg/kg twice daily. As ivermectin adoption for COVID-19 increased, the Food and Drug Administration (FDA) issued a warning on its use during the pandemic. However, the drug remains of interest to clinicians and has shown some promise in observational studies. This narrative reviews the toxicological profile and some potential therapeutic effects of ivermectin. Based on the current dose recommendation, ivermectin appears to be safe with minimum side effects. However, serious questions remain about the effectiveness of this drug in the treatment of patients with COVID-19.

Disease Waves of SARS-CoV-2 in Iran Closely Mirror Global Pandemic Trends.

BACKGROUND: Complete SARS-CoV-2 genome sequencing in the early phase of the outbreak in Iran showed two independent viral entries. Subsequently, as part of a genome surveillance project, we aimed to characterize the genetic diversity of SARS-CoV-2 in Iran over one year after emerging. METHODS: We provided 319 SARS-CoV-2 whole-genome sequences used to monitor circulating lineages in March 2020-May 2021 time interval. RESULTS: The temporal dynamics of major SARS-CoV-2 clades/lineages circulating in Iran is comparable to the global perspective and represent the 19A clade (B.4) dominating the first disease wave, followed by 20A (B.1.36), 20B (B.1.1.413), 20I (B.1.1.7), leading the second, third and fourth waves, respectively. We observed a mixture of circulating B.1.36, B.1.1.413, B.1.1.7 lineages in winter 2021, paralleled in a fading manner for B.1.36/B.1.1.413 and a growing rise for B.1.1.7, prompting the fourth outbreak. Entry of the Delta variant, leading to the fifth disease wave in summer 2021, was detected in April 2021. This study highlights three lineages as hallmarks of the SARS-CoV-2 outbreak in Iran; B4, dominating early periods of the epidemic, B.1.1.413 (B.1.1 with the combination of [D138Y-S477N-D614G] spike mutations) as a characterizing lineage in Iran, and the co-occurrence of [I100T-L699I] spike mutations in half of B.1.1.7 sequences mediating the fourth peak. It also designates the renowned combination of G and GR clades' mutations as the top recurrent mutations. CONCLUSION: In brief, we provided a real-time and comprehensive picture of the SARS-CoV-2 genetic diversity in Iran and shed light on the SARS-CoV-2 transmission and circulation on the regional scale.

SARS-CoV-2 outbreak in Iran: The dynamics of the epidemic and evidence on two independent introductions.

The SARS-CoV-2 virus has been rapidly spreading globally since December 2019, triggering a pandemic, soon after its emergence. While Iran was among the first countries confronted with rapid spread of virus in February 2020, no real-time SARS-CoV-2 whole-genome tracking in early phase of outbreak was performed in the country. To address this issue, we provided 50 whole-genome sequences of viral isolates ascertained from different geographical locations in Iran during March-July 2020. The corresponding analysis on origins, transmission dynamics and genetic diversity of SARS-CoV-2 virus, represented at least two introductions of the virus into the country, constructing two major clusters defined as B.4 and B.1*. The first entry of the virus might have occurred around very late 2019/early 2020, as suggested by the time to the most recent common ancestor, followed by a rapid community transmission that led to dominancy of B.4 lineage in early epidemic till the end of June. Gradually, reduction in dominancy of B.4 occurred possibly as a result of other entries of the virus, followed by surge of B.1* lineages, as of mid-May. Remarkably, variation tracking of the virus indicated the increase in frequency of D614G mutation, along with B.1* lineages, which showed continuity till October 2020. The increase in frequency of D614G mutation and B.1* lineages from mid-May onwards predicts a rapid viral transmission that may push the country into a critical health situation followed by a considerable change in composition of viral lineages circulating in the country.

Characterization of the biosurfactant produced by Pesudomonas areuginosa strain R 4 and its application for remediation pyrene-contaminated soils.

A biosurfactant producing strain was isolated and the rhamnolipid type biosurfactant was extracted for soil washing of a synthetically and naturally hydrocarbon-contaminated soil. Following the primary screening, Pseudomonas aeruginosa strain R 4 was selected and the effect of the carbon and nitrogen source and the salinity on biosurfactant production was studied. Of the best results were observed for glucose as a carbon source, NH4Cl as a nitrogen source and salinity of 1.4%. The produced biosurfactant was a glycolipid type biosurfactant and reduced the surface tension to 32.5 mN/m with a critical micelle concentration (CMC) of 50 mg/L and production yield of 90 mg/L. Using produced biosurfactant, a pyrene desorption rate of 82% was observed in selected conditions for initial pyrene concentration of 200 mg/L.

A salt resistant biosurfactant produced by moderately halotolerant Pseudomonas aeruginosa (AHV-KH10) and its application for bioremediation of diesel-contaminated sediment in saline environment.

A halotolerant bacterial strain was isolated from oily-contaminated sites of Persian Gulf, which characterized as Pseudomonas aeruginosa (AHV-KH10) by 16S rRNA gene sequencing. This strain was used for bioremediation of diesel-contaminated sediments. Biosurfactant production was initially screened by using oil displacement test and drop-collapse method, followed by measurement of surface tension (ST) of growth medium. Produced biosurfactant was a rhamnolipid type biosurfactant and lowered the ST to 33.4 mN/m at the given critical micelle concentration (CMC) of 75 mg/L. Addition of 3 CMC rhamnolipid, inoculums size of 15 mL, biodegradation in slurry phase and salinity level of 6% led totally to a diesel biodegradation rate of 70% for initial concentration of 1000 mg/kg after 35 days. The maximum diesel removal occurred at the salinity content of 6% indicating the moderately halo-tolerant characteristics of isolated strain. Evaluation of bacterial growth showed a biomass yield of 0.33 mg VSS/mg diesel in selected conditions. The field performance of Pseudomonas aeruginosa AHV-KH10 was proved through the removal of the TPH content in unwashed sediment, which varied from 2390 to 1875 mg/kg within four months.

Petroleum Contaminated Seawater Detoxification in Microcosm by Halotolerant Consortium Isolated from Persian Gulf.

Bioremediation of a petroleum contaminated seawater from Persian Gulf was investigated and efficiency of natural attenuation by native halotolerant bacterial consortium, biostimulation by addition of macro nutrients (nitrogen and phosphorus) and surfactant and bioaugmentation by application of halotolerant hydrocarbon degrading strains were evaluated. Biodegradation rates in defined conditions were studied for 30 days. Four pure isolates including Bacillus sp. PG-1, Pseudomonas aeruginosa PG-2, Paenibacillus lautus PG-3, and Pseudomonas putida PG-4 were used to preparation of bacterial consortium. Results indicated that the bioaugmentation yielded the best TPH removal efficiency of 56.24%, followed by biostimulation with surfactant addition (removal of 31.52%). The most bacterial density was also observed for bioaugmentation bioreactor. Toxicity of reaction medium was evaluated by oxygen consumption rate inhibition, dehydrogenase activity inhibition and growth rate inhibition methods in which, the least toxicity rates of 27%, 25% and 31% were observed for bioaugmentation based bioreactor, respectively. Simultaneous bioaugmentation and biostimulation can efficiently reduce the crude oil content in the surface of seawater using halotolerant strains.

Remediation of oily sludge wastes using biosurfactant produced by bacterial isolate Pseudomonas balearica strain Z8.

Biological treatment of oily sludge wastes was studied using an isolated halo-tolerant strain Pseudomonas balearica strain Z8. An oily sludge sample was obtained from oil fields of south waste of Iran and was fully characterized. The initial TPH content was 44,500 mg kg-1. The ability of Pseudomonas balearica strain Z8 in production of biosurfactant was investigated using oil displacement method. Results demonstrated that isolated strain is a biosurfactant producing bacteria. The CMC and emulsification index [E24] of produced biosurfactant were 90 mg L-1 and 44% for crude oil. Effect of operational parameters including nitrogen source, sludge/water ratio and temperature were investigated against the time. The most TPH removal of 35% was observed for nitrogen source of NH4Cl, sludge/ water ratio of 1:7 and temperature of 40 °C.

Prevalence of hepatitis C virus among HIV-infected patients.

BACKGROUND AND OBJECTIVES: Hepatitis C virus and Human Immunodeficiency Virus (HIV) share the same rate of transmission. HIV/HCV co-infected individuals may result in faster progression of liver fibrosis and highly increase the risk of cirrhosis, hepatocellular carcinoma development. Thus this study was conducted to determine co-infection of HCV genotypes in positive HIV patients in Ahvaz city, Iran. MATERIALS AND METHODS: The sera samples were collected from confirmed 78 infected HIV, 67 (85.89%) males and 11 (14.1%) females. All sera samples were tested for HCV Ab using ELISA test. The HCV Ab positive samples were tested for detection of 5' untranslated (UTR) and core regions of HCV genome using nested RT-PCR. The PCR products of 5UTR and core regions were sequenced to determine HCV genotypes. RESULTS: Among the 78 infected HIV, 25 (32.05%) cases including 20 (25.64%) males and 5 (6.41%) females were positive for HCV Ab (p=0.316). 53 (67.94%) of HIV patients were negative for HCV Ab. Among 25 positive HCV Ab, 19 (24.35%) cases including 15 (19.23%) males and 4 (5.12%) females were positive for HCV RNA (p=0.447). The PCR products of 5 positive samples were randomly sequenced. The results of sequences and alignments showed that the detected HCV genotypes were three 3a and two 1a. The occurrence of genotype HCV 1a was found in one male injecting drug user Injecting Drug User (IDU) and one female. The HCV 3a genotype was detected in the three males IDU. CONCLUSION: The results of this survey indicated that 32.05% of HIV patients were positive for HCV Ab, among them 24.35% were positive HCV RNA. HCV genotype 3a was dominant and detected in the three males IDU. Regarding the consequences of HIV/HCV co-infection, it is suggested that HCV RNA detection should be regularly checked in individuals infected with HIV.

Prevalence of Hepatitis B and C among Drug-Abusing Male Prisoners in Birjand, South Khorasan, Iran.

BACKGROUND: To estimate the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) and the associated risk factors among drug-abusing prisoners in Birjand correctional facility. METHODS: This is a cross-sectional study on 300 drug-abusing prisoners in 2016. Data were collected through questionnaires and interviews. HBV infection and HCV exposure status of the participants were determined by HBsAg, HBcAb, and HCVAb blood tests using third-generation enzyme immune assays (ELISA). The chi-square test was used to investigate the associations between risk factors and status of HBV infection and HCV exposure. All data were analyzed with SPSS software and P<0.05 was considered as significant difference. RESULTS: The mean age of participants was 37.4 ± 9.4 years with a range of 20-78 years. The prevalence rates of HBV exposure (total HBcAb) and infection (HBsAg) were 20.7 and 3.3% respectively, and the prevalence of HCV exposure (HCV Ab) was 8%. No co-infection was observed. Seroprevalence results for injecting drug users (IDUs) was 13 (18.8%) for total HBcAb, 1 (1.4%) for HBsAg, and 13 (18.8%) for HCVAb. There was no significant difference between the IDUs and non-IDUs in terms of HBsAg and total HBcAb positive rate, but the prevalence of HCV was significantly higher in the IDUs (P < 0.001). In logistic regression analysis, the main risk factors for HCV exposure in the entire samples was injecting drug use and having tattoos (OR = 4.08, 95% CI: 1.64-10.17, P = 0.003). CONCLUSION: We found a high rate of HBV and HCV infection in drug-using prison inmates compared to the general population of this area. The main risk factors associated with HCV infection in the prison populations with history of drug abuse were injecting drug use and having tattoo.

Remediation of PAHs contaminated soil using a sequence of soil washing with biosurfactant produced by Pseudomonas aeruginosa strain PF2 and electrokinetic oxidation of desorbed solution, effect of electrode modification with Fe3O4 nanoparticles.

This work aimed to investigate the performance of biosurfactant, produced by a halotolerant bacterial strain, Pseudomonas aeruginosa PF2, for desorption of PAHs from soil, followed by electrokinetic oxidation of the desorbed solution using Magnetite Nanoparticles Modified Graphite (MNMG). Pyrene (PYR), anthracene (ANT) and phenanthrene (PHE) were used as contamination model. Produced and extracted biosurfactant was characterized as rhamnolipid with Critical Micelle Concentration (CMC) of 60 mg/L and emulsification index (E24) value of 60.2% for n-hexadecane, 58.4% for n-heptane and 55.6% for n-Hexane, respectively. Results of LC-MS/MS analysis indicated the presence of seven major peaks at m/z of 677.5, 531.1, 649.3, 528.9, 475.1, 359 and 503.2, which corresponded to the deprotonated molecules of RhaRhaC12C10, RhaC12C10, RhaRhaC10C10, RhaC12:1C10, RhaC8C10, Rha-C12:2 and RhaC10C10, respectively. The maximum desorption of PAHs was derived at pH value of 6, CMC of 3 and contact time of 24 h. Modification of graphite electrode enhanced the PAH degradation significantly. In electrokinetic oxidation of desorbed solution, the best results were observed at pH value of 5, contact time of 6 h, voltage of 3 V and electrolyte concentration of 25 mg/L, with the average removal efficiency of higher than 99% for all studied PAHs.

Prevalence and genetic diversity of HCV among HIV-1 infected individuals living in Ahvaz, Iran.

BACKGROUND: To explore the prevalence, transmission routes and genotypes distribution of HCV in HIV-1/HCV co-infected individuals in Ahvaz, Iran. METHODS: The present cross-sectional study was conducted among HIV adult voluntary counseling and testing (VCT) clients, from September to November 2016. Reverse transcription (RT) nested PCR was performed to amplify the HCV core and 5'UTR regions from 90 HIV/HCV co-infected individuals. The PCR products were then sequenced for HCV subtyping. Genetic analysis was done by MEGA6 software. RESULTS: The prevalence of HCV in HIV-1-infected individuals was 58.7%. Injection drug use (IDU) was the most common route (99.1%) of transmission, and most of the patients (97.8%) had a history of imprisonment. The HCV subtypes were identified as 1a (55.2%), 3a (35.8%), 3 h (4.5%), 1b (3%) and 4a (1.5%) respectively, HCV 1a and 3a subtypes were predominant. CONCLUSIONS: The diversity of HCV subtypes in HIV-1/HCV co-infected individuals in Ahvaz city was high, although two subtypes (1a and 3a) are predominant.

Correction to: Prevalence of HIV-1 transmitted drug resistance in recently infected, treatment-naïve persons in the Southwest of Iran, 2014-2015.

The author would like to correct the error in the online published article. The correct details are given below for your reading.

Antiviral effects of Lactobacillus crispatus against HSV-2 in mammalian cell lines.

BACKGROUND: Herpes simplex virus type 2 (HSV-2) infectious disease is one of the most common viral sexually transmitted diseases. As regards, vaginal lactobacilli play an important role in protecting host against the urogenital pathogens; here we assessed the potential antiviral activity of Lactobacillus crispatus against HSV-2 infection in vitro. METHODS: Both Vero and HeLa cell lines were treated by L. crispatus before, during and after HSV-2 infection. The pre-incubation assay was also performed for the evaluating of virus adsorption by L. crispatus. Virus titer reduction in each stage was determined by a plaque reduction assay. RESULTS: L. crispatus significantly decreased the infectivity of the HSV-2 in initial steps on both cell lines; however, no significant inhibition was ascertained during adsorption and multiplication process. The lactobacilli adhere on Vero cells two-fold stronger than HeLa and subsequently protect the Vero cells nearly 2.5 fold higher than HeLa cell against the virion. Co-incubation of HSV-2 with bacterial cells prior to virus inoculation significantly decreased the virus titer. CONCLUSION: L. crispatus appears to inhibit the entry of the virus into cells by trapping HSV-2 particles. In addition, formation of L. crispatus microcolonies in the cell surface could block HSV-2 receptors and prevent viral entry to cells in initial infection steps.

Prevalence of HIV-1 transmitted drug resistance in recently infected, treatment-naïve persons in the Southwest of Iran, 2014-2015.

The emergence and transmission of drug resistant HIV mutants is a major concern, especially in resource-limited countries with expanding antiretroviral therapy. Studies have recently reported the prevalence of HIV-1 transmitted drug resistance (TDR) mutations in certain Iranian cities; however, no information is currently available about the level of TDR, as well as the nature of the circulating HIV-1 subtypes, in the Southwestern bordering province of Iran, Khuzestan. Herein, we used a WHO-recommended TDR survey method to classify the prevalence of TDR in indigenous people of Khuzestan province. For this purpose, between March 2014 and February 2015, blood samples were collected from 52 newly diagnosed, antiretroviral treatment-naïve, HIV-1 infected persons aged from 18 to 30 years. TDR mutations were determined by sequencing the protease (PR) and reverse transcriptase (RT) genes and interpreted using the WHO drug resistance mutations surveillance list. HIV-1 subtypes were characterized by sequencing the PR-RT, C2-V5, and p17 regions of the pol, env and gag genes, respectively. Two participants had non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance mutations, specifically K103N in one individual and K101EK/K103KN/G190AG in the other. No nucleoside reverse transcriptase inhibitor (NRTI) or major protease inhibitor (PI) mutations were identified. HIV-1 subtyping revealed that all participants were infected with HIV-1 CRF35_AD. According to the WHO sequential sampling method, the prevalence of HIV-1 TDR in the sampling area (Khuzestan province) was classified as moderate for NNRTIs and low for NRTIs and PIs. This is the first HIV-1 drug resistance threshold survey in the Khuzestan province of Iran and shows a predominance of NNRTI TDR mutations in this area.