Drug resistance of HIV-1 among ART-naive recently infected patients in the Irkutsk region

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Objective. Determination of the prevalence of transmissible drug resistance (DR) and resistance to antiretroviral therapy (ART) drugs among recently infected HIV patients with no experience of receiving ART in the Irkutsk region.

Materials and methods. In 2019 and 2023, 2 threshold studies of transmissible HIV DR were conducted in patient samples of the Irkutsk Regional Center for the Prevention and Control of AIDS and Infectious Diseases. Both studies used blood plasma from 50 HIV-infected individuals with no experience of ART, with an estimated infection duration of no more than 1 year and a CD4+ level of more than 500 cells/μl at the time of the study.

Results. Mutations of the transmitted DR were detected in samples from 3 patients in 2019 and 6 in 2023 (6% (90% CI 0.5–11.5%) and 12% (90% CI 4.4–19.6%), respectively). In the 2019 sample, 2 patients (4%) had mutations of DR to non-nucleoside reverse transcriptase inhibitors (NNRTIs) and 1 patient (2%) had mutations of DR to protease inhibitors (PIs). In 2023, the following DR variants were detected: 2 patients (4%) with DR to PIs, 2 patients (4%) with DR to NNRTIs, 1 patient (2%) with DR to NRTIs+NNRTIs (2%), and 1 patient (2%) with DR to PIs+NNRTIs. According to the phylogenetic analysis, in the 2019 sample, 1 (2%) sample clustered with subtype B, 5 (10%) – with the recombinant CRF63 02_A6, the remaining 44 (88%) samples were typed as A6. In 2023, the following distribution was revealed: A6 – 90%, CRF63 02_A6 – 8%, B –2%.

Conclusion. Transmissible HIV DR in the Irkutsk region has currently settled at 12%, which does not exceed the threshold of 15%, after which it is necessary to test each patient before prescribing ART. It is advisable to conduct a repeat study for transmissible DR after 2 years to assess the dynamics of the spread of resistant HIV strains.

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Sobre autores

Aleksandr Revizor

Irkutsk Regional Center for the Prevention and Control of AIDS and Infectious Diseases

Autor responsável pela correspondência
Email: rao@aids38.ru
ORCID ID: 0000-0002-6876-124X

Biologist, Clinical Diagnostic Laboratory № 3

Rússia, Irkuts

Yulia Plotnikova

Irkutsk Regional Center for the Prevention and Control of AIDS and Infectious Diseases; Irkutsk State Medical Academy of Postgraduate Education – Branch Campus of the Russian Medical Academy of Continuous Professional Education, Ministry of Health of the Russia

Email: plot18@yandex.ru
ORCID ID: 0000-0003-2912-9118

Cand. Med. Sci, Chief Physician, Associate Professor

Rússia, Irkutsk; Irkutsk

Olga Ponomareva

Irkutsk Regional Center for the Prevention and Control of AIDS and Infectious Diseases

Email: poa@aids38.ru
ORCID ID: 0000-0001-9154-211X

Physician, Head of Clinical Diagnostic Laboratory №3

Rússia, Irkuts

Aleksey Shulunov

Irkutsk Regional Center for the Prevention and Control of AIDS and Infectious Diseases

Email: Shulunov18@gmail.com
ORCID ID: 0009-0008-5034-3390

Physician

Rússia, Irkuts

Nikolay Cherkasov

Irkutsk Regional Center for the Prevention and Control of AIDS and Infectious Diseases

Email: mto_cherkasov_nn@mail.ru
ORCID ID: 0009-0006-1343-7051

Biologist, Clinical Diagnostic Laboratory №3

Rússia, Irkuts

Petr Vershinin

Irkutsk Regional Center for the Prevention and Control of AIDS and Infectious Diseases

Email: petr0trep@gmail.com
ORCID ID: 0009-0008-4605-9450

Biologist, Clinical Diagnostic Laboratory №3

Rússia, Irkuts

Elena Naumova

Irkutsk Regional Center for the Prevention and Control of AIDS and Infectious Diseases

Email: Naumova_e_s26@mail.ru
ORCID ID: 0009-0005-2724-6718

Physician, Clinical Diagnostic Laboratory № 3

Rússia, Irkuts

Ekaterina Kuznetsova

Irkutsk Regional Center for the Prevention and Control of AIDS and Infectious Diseases

Email: Atomarnaya@mail.ru
ORCID ID: 0009-0006-6967-6342

Physician, Clinical Diagnostic Laboratory № 3

Rússia, Irkuts

Alena Tankhaeva

Irkutsk Regional Center for the Prevention and Control of AIDS and Infectious Diseases

Email: alena.pilueva@mail.ru
ORCID ID: 0009-0009-9753-7042

Biologist, Clinical Diagnostic Laboratory № 3

Rússia, Irkuts

Polina Polyakova

Irkutsk Regional Center for the Prevention and Control of AIDS and Infectious Diseases

Email: poly.poliackova28@yandex.ru
ORCID ID: 0009-0004-4880-6828

Biologist, Clinical Diagnostic Laboratory № 3

Rússia, Irkuts

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2. Fig. 1. Prevalence of transmissible HIV DR by ART drug groups in the 2019 and 2023 samples

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3. Fig. 2. Phylogenetic analysis of the HIV-1 po/gene region encoding protease and 1-273 amino acid of reverse transcriptase, carried out according to the maximum likelihood principle using the MEGA 11 program ◆ — 2019 sample, ● —2023 sample

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