HIV-1 Drug Resistance among Treatment-Naïve Patients in Russia: Analysis of the National Database, 2006–2022

Abstract

In Russia, antiretroviral therapy (ART) coverage has significantly increased, which, in the absence of routine genotyping testing, could lead to an increase in HIV drug resistance (DR). The aim of this study was to investigate the patterns and temporal trends in HIV DR as well as the prevalence of genetic variants in treatment-naïve patients from 2006 to 2022, using data from the Russian database (4481 protease and reverse transcriptase and 844 integrase gene sequences). HIV genetic variants, and DR and DR mutations (DRMs) were determined using the Stanford Database. The analysis showed high viral diversity, with the predominance of A6 (78.4%), which was the most common in all transmission risk groups. The overall prevalence of surveillance DRMs (SDRMs) was 5.4%, and it reached 10.0% in 2022. Most patients harbored NNRTI SDRMs (3.3%). The prevalence of SDRMs was highest in the Ural (7.9%). Male gender and the CRF63_02A6 variant were association factors with SDRMs. The overall prevalence of DR was 12.7% and increased over time, primarily due to NNRTIs. Because baseline HIV genotyping is unavailable in Russia, it is necessary to conduct surveillance of HIV DR due to the increased ART coverage and DR prevalence. Centralized collection and unified analysis of all received genotypes in the national database can help in understanding the patterns and trends in DR to improve treatment protocols and increase the effectiveness of ART. Moreover, using the national database can help identify regions or transmission risk groups with a high prevalence of HIV DR for epidemiological measures to prevent the spread of HIV DR in the country.

Features of Tat Protein in HIV-1 Sub-Subtype A6 Variants Circulating in the Moscow Region, Russia

“…In 250/252 clinical samples, the virus sub-subtype A6 was identified, in 1/252-subtype B, in 1/252-CRF02_AG. These results are consistent with the data that show subtype A6 is still the major HIV-1 subtype in Central Russia and the Moscow Region in particular [16,31].…”

Current Trends of HIV Infection in the Russian Federation

“…The aging of the HIV-infected population has also been noted due to the increased life expectancy resulting from ART [9]. Previous studies on HIV infection at the regional level in Russia have primarily focused on molecular genetic analysis of HIV and its drug resistance [7,[10][11][12][13][14][15].…”

Development of a method for the quantitative determination of ritonavir and lopinavir in blood plasma

“…В результате применяемая схема АРТ оказывается неэффективной, вирусная нагрузка продолжает нарастать за счёт резистентного штамма ВИЧ, болезнь прогрессирует [5], кроме того в популяции начинают циркулировать резистентные штаммы ВИЧ. Так в Российской Федерации распространённость первичной лекарственной устойчивости за период 2006-2022 года составляла 5,4%, а в 2022 году достигла 10% [6].…”