Drug resistance of HIV-1 among patients without experience with antiretroviral therapy in the North Caucasus Federal District


DOI: https://dx.doi.org/10.18565/epidem.2025.15.3.28-34

Kirichenko A.A., Kireev D.E., Lapovok I.A., Kolpakov D.S., Suladze A.G., Bekmurzieva L.K., Gandaloev I.I., Suleymanov I.Z., Murtazaliev Kh.Kh., Daltsayeva M.K., Rtishcheva L.V., Shungarova O.A., Bobkov V.G., Bobkova M.R., Akimkin V.G.

1) Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; 2) Rostov Research Institute of Microbiology and Parasitology, Rostov-on-Don, Russia; 3) Republican Center for the Prevention and Control of AIDS and Other Infectious Diseases, Nazran, Republic of Ingushetia, Russia; 4) Republican Clinical Center for Infectious Diseases, Prevention and Control of AIDS, Grozny, Chechen Republic, Russia; 5) Karachay-Cherkess Republican Infectious Diseases Clinical Hospital and Center for the AIDS Prevention and Control, Cherkessk, Karachay-Cherkess Republic, Russia; 6) Mechnikov Research Institute of Vaccines and Serums, Moscow, Russia
Objective. Evaluation of the structure and prevalence of HIV-1 drug resistance (DR) among patients with no experience of antiretroviral therapy (ART) living in the North Caucasus Federal District (NCFD).
Materials and methods. HIV-1 nucleotide sequences and accompanying clinical and epidemiological information from 122 HIV-infected patients with no experience of ART living in the NCFD, obtained from 2010 to 2024, were analyzed. Resistance mutations and prognostic DR of HIV-1 were determined using the Stanford University HIVdb database (v. 9.6). Molecular clusters of HIV-1 with a genetic distance threshold of less than 2.0% were identified using the MicrobeTrace tool.
Results. HIV-1 DR was detected in 27.9% of patients, most frequently to drugs of the class of non-nucleoside reverse transcriptase inhibitors (NNRTIs) – nevirapine (NVP) (23.0%) and efavirenz (EFV) (21.3%). The prevalence of mutations significant for surveillance was 22.1%. As a result of the analysis of molecular clusters, it was found that the high prevalence of HIV-1 DR in the study sample is due to the transmission of HIV-1 variants containing K103N/S mutations, which indicates the problem of transmitted HIV-1 DR in the district. At the same time, as a result of the assessment of HIV-1 DR in epidemiologically unrelated individuals, it was shown that the prevalence of primary HIV-1 DR and mutations significant for surveillance was 16.5 and 9.4%, respectively.
Conclusion. A high risk of spreading primary HIV-1 resistance to first-generation NNRTIs in the North Caucasus Federal District has been demonstrated, which requires measures to prevent the emergence and further spread of DR-HIV-1 variants.
Keywords: North Caucasus Federal District, transmission clusters, molecular clusters, HIV-1, resistance mutations, drug resistance, antiretroviral therapy
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About the Autors

Alina A. Kirichenko, Cand. Med. Sci., Senior Scientific Researcher, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; kirichenko@cmd.su; https://orcid.org/0000-0002-7116-0138
Dmitry E. Kireev, Cand. Biol. Sci., Head, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; dmitry.kireev@pcr.ms; https://orcid.org/0000-0002-7896-2379
Ilya A. Lapovok, Cand. Biol. Sci., Senior Scientific Researcher, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; lapovok@cmd.su; https://orcid.org/0000-0002-6328-1415
Dmitry S. Kolpakov, Head of Laboratory, Rostov Research Institute of Microbiology and Parasitology, Rostov-on-Don, Russia; dimakolpakov@mail.ru; https://orcid.org/0009-0007-7604-4631
Alexander G. Suladze, Cand. Med. Sci., Acting Director, Rostov Research Institute of Microbiology and Parasitology, Rostov-on-Don, Russia; sualrostov@mail.ru; https://orcid.org/0000-0002-9051-1220
Luiza K. Bekmurzieva, Chief Physician, Republican Center for the Prevention and Control of AIDS and Other Infectious Diseases, Nazran, Republic of Ingushetia, Russia; luizabays@mail.ru; https://orcid.org/0009-0000-0163-7933
Ibragim I. Gandaloev, Head of Laboratory, Republican Center for Prevention and Control of AIDS and Other Infectious Diseases, Nazran, Republic of Ingushetia, Russia; gandaloev93@bk.ru; https://orcid.org/0009-0007-8566-5763
Ihsan Z. Suleymanov, Deputy Chief Physician, Republican Clinical Center for Infectious Diseases, Prevention and Control of AIDS, Grozny, Chechen Republic; ihsansuleymanov@gmail.com; https://orcid.org/0009-0007-3595-3329
Khamzat Kh. Murtazaliev, Chief External Expert, Chief Physician, Republican Clinical Center for Infectious Diseases, Prevention and Control of AIDS, Grozny, Chechen Republic, Russia; hiv-chr@mail.ru; https://orcid.org/0009-0003-4524-5730
Markha K. Daltsaeva, Deputy Chief Physician, Republican Clinical Center for Infectious Diseases, Prevention and Control of AIDS, Grozny, Chechen Republic, Russia; marha-epid@yandex.ru; https://orcid.org/0009-0007-3595-3329
Lyudmila V. Rtishcheva, Chief Physician, Karachay-Cherkess Republican Infectious Diseases Clinical Hospital and the Center for the AIDS Prevention and Control, Cherkessk, Karachay-Cherkess Republic, Russia; infekcia73@mail.ru; https://orcid.org/0009-0001-7399-3977
Oksana A. Shungarova, Infectious Diseases Specialist, Karachay-Cherkess Republican Infectious Diseases Clinical Hospital and the Center for the AIDS Prevention and Control, Cherkessk, Karachay-Cherkess Republic, Russia; aminova@mail.ru; https://orcid.org/0009-0007-6094-6091
Vyacheslav G. Bobkov, IT Engineer, I.I. Mechnikov Research Institute of Vaccines and Serums, Moscow, Russia; vbobkov@gmail.com; https://orcid.org/0000-0003-0869-6594
Marina R. Bobkovam, Chief Specialist, I.I. Mechnikov Research Institute of Vaccines and Serums, Moscow, Russia; mrbobkova@mail.ru; https://orcid.org/0000-0001-5481-8957
Рrofessor Vasily G. Akimkin, MD, Academician of the Russian Academy of Sciences, Director, Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being, Moscow, Russia; crie@pcr.ru; https://orcid.org/0000-0003-4228-9044


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