Analysis of the prevalence of HIV-1 primary resistance to antiretroviral medicinal agents in Novosibirsk region

Timely detection of HIV variations resistant to antiretroviral medicines (ARM) and correction of the therapeutic direction can prevent the formation of mutations. The aim of the research is to study the prevalence of primary HIV-1 resistance to ARM in patients with HIV infection in Novosibirsk region in 2021. Material and methods. We examined 119 patients with newly diagnosed HIV infection aged 22 to 66 years old, who were observed in city clinical hospital No.1 in Novosibirsk in 2021. The nucleotide sequence of HIV-1 genome fragments encoding the protease and reverse transcriptase of the virus was studied, the HIV-1 genotype was determined, and the analysis for the presence of mutations associated with the development of virus resistance to ARM was made. Results. Among the 119 examined patients with HIV infection, males predominated - 68,1%. Among the ways of HIV infection transmission heterosexual transmission dominated - 61,3%. HIV-1 genotyping revealed 6 HIV genetic variants in 110 patients: subtype A6 (12,7%), subtype B (1,8%), CRF63_02A6 (80,9%), CRF01_AE (1,8%), CRF02_AGFSU (0,9%) and two variants of unique recombinant HIV (URF) formed with the participation of subtype A6 and CRF63_02A6 (0,9% each). According to the main list of mutations subject to surveillance for primary HIV-1 resistance, 16 resistant variants of HIV-1 were found - in 13,4% of the study group of patients. Based on the totality of all identified mutations (including those subject to surveillance), primary resistant variants of HIV-1 were detected in 19,3% of cases (n=23 from 119). More often than others, isolated mutations to drugs from the NNRTI group were registered -in 61,0% (n=14 from 23); isolated mutations to NRTIs were fixed in 21,8% (n=5 of 23), combination of mutations to NRTIs + nNrTIs in 12,9% (n=3 of 23), mutations to PIs + NnRTIs in 4,3% of patients (n=1 from 23). In patients with HIV resistance mutations (n=23), K103N was most common - alone (30,6%) and in combination with P225H or K70T (4,3% each). Most often, a high level of resistance was detected to ARPs of the NNRTI group - efavirenz (7,5%) and nevirapine (8,4%). The average level of resistance in isolated cases was registered to etravirine, rilpivirine and efavirenz (0,8% each). Conclusion. Among the naive HIV-infected, the prevalence of primary HIV-1 resistance to ART corresponds to the average level for the territories of Russia - 13,4%. Among HIV resistance mutations (n=23), K103N was the most common one (30,6%) and also in combination with P225H and K70T (4,3% each).

HIV infection, AIDS, resistance, antiretroviral medicinal agents, mutations