Analysis of the spread of drug resistance mutations in the HIV-1 pol gene among the HIV-infected in the Irkutsk Region

Objective. To estimate the situation associated with the spread of HIV subtypes, recombinant forms, and resistant variants in the Irkutsk Region. Material and methods. The paper gives the data of analyzing the nucleoside sequences of the HIV-1 pol gene encoding the enzymes: protease, reverse transcriptase, and integrase. The investigation used plasma from 65 HIV-infected patients residing in the Irkursk Region. Commercial test systems were employed to isolate RNA and reverse transcription-polymerase chain reaction and cyclic sequencing were carried out. Nucleotide sequences were detected by capillary electrophoresis in an automated molecular analyzer. Results. Phylogenetic analysis showed that 62 (95.38%) sequences were clustered with the HIV-1 genetic subtype A1 IDU-A variant, 2 samples were grouped with the recombinant form CRF02-AG, and one sample was with subtype B. Antiretroviral drug-resistant virus strains were detected in 63% of the patients. There was a broad spectrum of drug-resistant strains: those resistant to protease inhibitors in 10.77% of cases, nucleoside reverse transcriptase inhibitors in 58.46%, non-nucleoside reverse transcriptase inhibitors in 35.38%, and integrase inhibitors in 3.08%. The proportion of mono- and multidrug-resistant (to two or more drug) strains was 34.15 and 65.85%, respectively. Conclusion. In the Irkutsk Region, there is a predominance of HIV-1 subtype A1; the detection of other subtypes suggests that the population’s migration may increase. The spectrum of drug-resistant strains corresponds to the highly active antiretroviral therapy regimens that are most commonly used in our region.

HIV infection, subtype, resistance, mutation