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

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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.

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Sobre autores

Alina Kirichenko

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Autor responsável pela correspondência
Email: kirichenko@cmd.su
ORCID ID: 0000-0002-7116-0138

Cand. Med. Sci., Senior Scientific Researcher

Rússia, Moscow

Dmitry Kireev

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: dmitry.kireev@pcr.ms
ORCID ID: 0000-0002-7896-2379

Cand. Biol. Sci., Head, Central Research Institute of Epidemiology

Rússia, Moscow

Ilya Lapovok

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: lapovok@cmd.su
ORCID ID: 0000-0002-6328-1415

Cand. Biol. Sci., Senior Scientific Researcher

Rússia, Moscow

Dmitry Kolpakov

Rostov Research Institute of Microbiology and Parasitology

Email: dimakolpakov@mail.ru
ORCID ID: 0009-0007-7604-4631

Head of Laboratory

Rússia, Rostov-on-Don

Alexander Suladze

Rostov Research Institute of Microbiology and Parasitology

Email: sualrostov@mail.ru
ORCID ID: 0000-0002-9051-1220

Cand. Med. Sci., Acting Director

Rússia, Rostov-on-Don

Luiza Bekmurzieva

Republican Center for the Prevention and Control of AIDS and Other Infectious Diseases

Email: luizabays@mail.ru
ORCID ID: 0009-0000-0163-7933

Chief Physician

Rússia, Nazran, Republic of Ingushetia

Ibragim Gandaloev

Republican Center for the Prevention and Control of AIDS and Other Infectious Diseases

Email: gandaloev93@bk.ru
ORCID ID: 0009-0007-8566-5763

Head of Laboratory

Rússia, Nazran, Republic of Ingushetia

Ihsan Suleymanov

Republican Clinical Center for Infectious Diseases, Prevention and Control of AIDS

Email: ihsansuleymanov@gmail.com
ORCID ID: 0009-0007-3595-3329

Deputy Chief Physician

Rússia, Grozny, Chechen Republic

Khamzat Murtazaliev

Republican Clinical Center for Infectious Diseases, Prevention and Control of AIDS

Email: hiv-chr@mail.ru
ORCID ID: 0009-0003-4524-5730

Chief External Expert, Chief Physician

Rússia, Grozny, Chechen Republic

Markha Daltsaeva

Republican Clinical Center for Infectious Diseases, Prevention and Control of AIDS

Email: marha-epid@yandex.ru
ORCID ID: 0009-0000-9746-4861

Deputy Chief Physician

Rússia, Grozny, Chechen Republic

Lyudmila Rtishcheva

Karachay-Cherkess Republican Infectious Diseases Clinical Hospital and Center for the AIDS Prevention and Control

Email: infekcia73@mail.ru
ORCID ID: 0009-0001-7399-3977

Chief Physician

Rússia, Cherkessk, Karachay-Cherkess Republic

Oksana Shungarova

Karachay-Cherkess Republican Infectious Diseases Clinical Hospital and Center for the AIDS Prevention and Control

Email: aminova@mail.ru
ORCID ID: 0009-0007-6094-6091

Infectious Diseases Specialist

Rússia, Cherkessk, Karachay-Cherkess Republic

Vyacheslav Bobkov

Mechnikov Research Institute of Vaccines and Serums

Email: vbobkov@gmail.com
ORCID ID: 0000-0003-0869-6594

IT Engineer

Rússia, Moscow

Marina Bobkova

Mechnikov Research Institute of Vaccines and Serums

Email: mrbobkova@mail.ru
ORCID ID: 0000-0001-5481-8957

Chief Specialist

Rússia, Moscow

Vasily Akimkin

Central Research Institute of Epidemiology, Russian Federal Service for Supervision of Consumer Rights Protection and Human Well-Being

Email: crie@pcr.ru
ORCID ID: 0000-0003-4228-9044

Professor, MD, Academician of the Russian Academy of Sciences, Director

Rússia, Moscow

Bibliografia

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2. Fig. 1. Prevalence of DR (a) and mutations of HIV-1 (b) * Surveillance drug resistance mutations (SDRMs)

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3. Fig. 2. Molecular clusters of HIV-1 The grey square indicates the HIV-1 nucleotide sequences that contain none of resistance mutations. The white square indicates nucleotide sequences of HIV-1 containing resistance mutations (within the square).

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