HIV-1 drug resistance in patients with virological inefficiency on ART in Russia in 2013–2021


DOI: https://dx.doi.org/10.18565/epidem.2021.11.3.53-62

Kirichenko A.A., Kireev D.E., Shlykova A.V., Lopatukhin A.E., Lapovok I.A., Saleeva D.V., Kravchenko A.V., Pokrovsky V.V.

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia
Objective. To assess the prevalence and pattern of HIV-1 drug resistance (DR) among patients with virological failure on ART in Russia in 2013 to 2021.
Materials and methods. The investigation used plasma samples from 831 HIV-infected patients with virological failure on ART. The nucleotide sequences of the pol gene fragments encoding protease and a part of reverse transcriptase were obtained for all the patients; for 273 of them, the nucleotide sequences of the pol gene fragment encoding HIV-1 integrase were additionally obtained.The Stanford University HIVdb version 9.0 and the REGA HIV-1 Subtyping Tool version 3.0 were used to determine HIV-1 subtypes; the HIV Blast search in the Los Alamos HIV sequence database was applied to clarify the results; the HIVdb version 9.0 was employed to identify resistance mutations and to determine the predictive HIV-1 DR.
Results. The sample included mainly the genetic types of virus A6 (728; 87.6%), CRF 02_AG (21; 2.5%), B (59; 7.1%), and CRF6_02A1 (15; 1,8%). 82.4% of patients with ineffective therapy showed a predictive DR to at least one drug: more commonly to NIOT (74.2%) and NNIOT (67.3%), less commonly to AI (12.1%) and IP (9.6%). Resistance to NIOT + NNRTI was simultaneously established in most cases (45.8–57%). Multiclass resistance to IP + NIOT + NNIOT + AI was detected only in 1.1% of cases.
Conclusion. There is a need for a centralized HIV-1 DR test for patients with virological falure on ART in order to select effective therapy regimens and to minimize the occurrence and further spread of resistant HIV-1 types in Russia.

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About the Autors


Alina A. Kirichenko, Researcher, Central Research Institute of Epidemiology, Federal Service for the Surveillance on Consumer Rights Protection and Human Well-Being; kotova-kirichenko@mail.ru; https://orcid.org/0000-0002-7116-0138
Dmitry E. Kireev, Cand. Med. Sci., Head, Laboratory of Diagnostics and Molecular Epidemiology of HIV infection, Central Research Institute of Epidemiology, Federal Service for the Surveillance on Consumer Rights Protection and Human Well-Being; dmitkireev@yandex.ru; https://orcid.org/0000-0002-7896-2379
Anastasia V. Shlykova, Researcher, Central Research Institute of Epidemiology, Federal Service for the Surveillance on Consumer Rights Protection and Human Well-Being; murzakova_a.v@mail.ru; https://orcid.org/0000-0002-1390-8021
Alexey E. Lopatukhin, Researcher, Central Research Institute of Epidemiology, Federal Service for the Surveillance on Consumer Rights Protection and Human Well-Being; a.lopatukhin@gmail.com; https://orcid.org/0000-0002-2826-699X
Ilya A. Lapovok, Cand. Biol. Sci., Senior Researcher, Central Research Institute of Epidemiology, Federal Service for the Surveillance on Consumer Rights Protection and Human Well-Being; i_lapovok@mail.ru; https://orcid.org/0000-0002-6328-1415
Daria V. Saleeva, Junior Researcher, Central Research Institute of Epidemiology, Federal Service for the Surveillance on Consumer Rights Protection and Human Well-Being; dasha_saleeva@inbox.ru; https://orcid.org/0000-0002-5870-5594
Professor Alexey V. Kravchenko, МD, Leading Researcher, Central Research Institute of Epidemiology, Russian Federal Service for Surveillance on Consumer Rights Protection and Human Well-Being; alexey-kravtchenko@yandex.ru; http://orcid.org/0000-0001-7857-3763
Professor Vadim V. Pokrovsky, Academician of the Russian Academy of Sciences, MD, Head, HIV Department, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being; pokrovsky.vad@yandex.ru; https://orcid.org/0000-0002-9514-7288; Scopus Author ID: 7202457043


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