Antiretroviral resistance testing results in patients with HIV living in the Primorye Krai

   Objective. To describe the drug resistance and genetic diversity of HIV-1 among patients in Primorsky Krai in 2024.

   Materials and methods. A biological material analysis was conducted on 122 HIV-infected patients under dispensary observation at the at the AIDS Center of Regional Hospital No. 2 (Vladivostok, Russia) in order to identify the drug resistance to four main classes of antiretroviral agents.

   Results. A high prevalence of genetic variants A6 (44.3 %), B (28.7 %), and C (8.2 %) of HIV-1 was observed among the examined patients. The likelihood of non-nucleoside reverse transcriptase inhibitor resistance was found to be tenfold higher in subtype B compared to subtype A6 (OR = 10.5). The integrase inhibitor resistance was significantly more frequently detected in the subgroup of patients with HIV-1 subtype B (OR = 38.1). In the overall patient sample, the drug resistance was identified in 19.7 % of cases for one group of antiretroviral medications, in 9 % for two groups, and in 2.5 % for three groups of medications. A recombinant form A6/CRF02_AG was detected in 8.2 % of cases. Additionally, 10.6 % of cases exhibited various genetic variants of HIV-1 which can be classified as new recombinant or unique forms.

   Conclusion. The results demonstrate a rising trend in recombinant types of HIV-1 within the region, reflecting changes in the overall genetic landscape of HIV subtypes, with significant variations in the mutation patterns associated with drug resistance across certain groups of antiretroviral therapy in both B and non-B subtypes of HIV.

1. UNAIDS. Fact sheet 2024. https://www.unaids.org/sites/default/files/media_asset/UNAIDS_FactSheet_en.pdf

2. Kitayimbwa JM, Mugisha JYT, Saenz RA. Estimation of the HIV-1 backward mutation rate from transmitted drug-resistant strains. Theor Popul Biol. 2016;112:33–42. doi: 10.1016/j.tpb.2016.08.001

3. Sun Z, Lan Y, Liang S, Wang J, Ni M, Zhang X,et al. Prevalence of doravirine cross-resistance in HIV-infected adults who failed first-line ART in China, 2014–18. J. Antimicrob. Chemother. 2022;77:1119–24. doi: 10.1093/jac/dkac016

4. Nastri BM, Pagliano P, Zannella C, Folliero V, Masullo A, Rinaldi L, et al. HIV and drug-resistant subtypes. Microorganisms. 2023;11: 221. doi: 10.3390/microorganisms11010221

5. Eliseeva VS, Kruglyak SP, Kovalenko GV, Korotkich LA. Characterization of the mutations of resistance of HIV-1 on the territory of Primorskiy territory. Pacific Medical Journal. 2019:3: 71–5 (In Russ.) doi: 10.17238/PmJ1609-1175.2019.3.71-75

6. Ekushov VE, Totmenin AV, Maksimenko LV, Sivai MV, Khalikov MR, Gorelova IS, et al. Genetic diversity of HIV-1 in the Primorsky Territory. Journal of Infectology. 2023:2: 38–9 (In Russ.)

7. Halikov MR, Ekushov VE, Totmenin AV, Gotfrid LG, Sklyar LF, Soloveva NP, et al. The role of recombination variability to the formation of the population the HIV-1 population circulating in the Primorsky Kray, Russia. South of Russia: Ecology, Development. 2023;4:125–33 (In Russ.) doi: 10.18470/1992-1098-2023-4-125-133

8. Nair M, Gettins L, Fuller M, Kirtley S, Hemelaar J. Global and regional genetic diversity of HIV-1 in 2010–21 : systematic review and analysis of prevalence. Lancet Microbe. 2024;5(11):100912. doi: 10.1016/S2666-5247(24)00151-4

9. Singh K, Flores JA, Kirby KA, Neogi U, Sonnerborg A, et al. Drug resistance in non-B subtype HIV-1: impact of HIV-1 reverse transcriptase inhibitors. Viruses. 2014;6(9):3535–62. doi: 10.3390/v6093535

10. Lambert-Niclot S, Charpentier C, Storto A, Fofana D, Soulie C, Fourati S, et al. Rilpivirine, emtricitabine and tenofovir resistance in HIV-1-infected rilpivirine-naive patients failing antiretroviral therapy. J Antimicrob Chemother. 2014:69:1086–9. doi: 10.1093/jac/dkt463