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Sivay MV, Maksimenko LV, Nalimova TM, Nefedova AA, Osipova IP, Kriklivaya NP, Gashnikova MP, Ekushov VE, Totmenin AV, Kapustin DV, Pozdnyakova LL, Skudarnov SE, Ostapova TS, Yaschenko SV, Nazarova OI, Shevchenko VV, Ilyina EA, Novikova OA, Agafonov AP, Gashnikova NM. HIV drug resistance among patients experiencing antiretroviral therapy failure in Russia, 2019-2021. Int J Antimicrob Agents 2024; 63:107074. [PMID: 38154660 DOI: 10.1016/j.ijantimicag.2023.107074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 11/15/2023] [Accepted: 12/20/2023] [Indexed: 12/30/2023]
Abstract
Increasing HIV drug resistance is an important public health concern. The current study aimed to assess HIV drug resistance among people who live with HIV (PLWH) experiencing virological failure. Blood samples and epidemiological characteristics were collected in four Siberian regions from PLWH experiencing ART failure. Partial pol gene sequences were obtained for the study individuals. Drug resistance mutations (DRMs) were predicted using the Stanford HIVdb Program. The association of HIV DRM with epidemiological characteristics was estimated using logistic regression analysis. Further analysis was performed for children (0-14 y old) and adults (≥15 y old) separately. In total, 815 (89.4%) patients were included in the final dataset. Overall, 501 (61.5%) patients had DRM detected. NRTI DRM was more common in children, while NRTI+NNRTI DRM was more frequent in adults (P < 0.001). Krasnoyarsk region, male sex and high viral load were positively associated with the presence of DRM in adults, while higher CD4 cell count and PI/INSTI-based ART had a negative association. No association between epidemiological characteristics and DRM was identified in children. The remaining 38.5% of patients with virological failure had no DRM detected; those patients were likely to have insufficient ART adherence. Most (55.5%) patients had HIV CRF63_02A6, followed by sub-subtype A6 (39.2%). This study revealed poor ART adherence as a main factor driving ART failure among PLWH in the Siberian region. DRM was detected in over 60% of PLWH experiencing ART failure. The current results highlight an urgent need for the introduction of special programs focusing on ART adherence improvement.
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Affiliation(s)
- Mariya V Sivay
- State Research Center of Virology and Biotechnology 'Vector', Novosibirsk region, Russia.
| | - Lada V Maksimenko
- State Research Center of Virology and Biotechnology 'Vector', Novosibirsk region, Russia
| | - Tatiana M Nalimova
- State Research Center of Virology and Biotechnology 'Vector', Novosibirsk region, Russia
| | - Anastasiya A Nefedova
- State Research Center of Virology and Biotechnology 'Vector', Novosibirsk region, Russia
| | - Irina P Osipova
- State Research Center of Virology and Biotechnology 'Vector', Novosibirsk region, Russia
| | - Nadezda P Kriklivaya
- State Research Center of Virology and Biotechnology 'Vector', Novosibirsk region, Russia
| | - Mariya P Gashnikova
- State Research Center of Virology and Biotechnology 'Vector', Novosibirsk region, Russia
| | - Vasiliy E Ekushov
- State Research Center of Virology and Biotechnology 'Vector', Novosibirsk region, Russia
| | - Alexei V Totmenin
- State Research Center of Virology and Biotechnology 'Vector', Novosibirsk region, Russia
| | | | | | - Sergey E Skudarnov
- Krasnoyarsk Regional Center for Prevention and Control of AIDS, Krasnoyarsk, Russia
| | - Tatyana S Ostapova
- Krasnoyarsk Regional Center for Prevention and Control of AIDS, Krasnoyarsk, Russia
| | - Svetlana V Yaschenko
- Krasnoyarsk Regional Center for Prevention and Control of AIDS, Krasnoyarsk, Russia
| | - Olga I Nazarova
- Omsk City Center for Prevention and Control of AIDS and Other Infectious Diseases, Omsk, Russia
| | - Valery V Shevchenko
- Altai Regional Center for Prevention and Control of AIDS and Other Infectious Diseases, Barnaul, Russia
| | - Elena A Ilyina
- Altai Regional Center for Prevention and Control of AIDS and Other Infectious Diseases, Barnaul, Russia
| | - Olga A Novikova
- Altai Regional Center for Prevention and Control of AIDS and Other Infectious Diseases, Barnaul, Russia
| | - Aleksander P Agafonov
- State Research Center of Virology and Biotechnology 'Vector', Novosibirsk region, Russia
| | - Natalya M Gashnikova
- State Research Center of Virology and Biotechnology 'Vector', Novosibirsk region, Russia
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Kireev D, Kirichenko A, Lebedev A, Bobkova M. Alarming Rise of Primary HIV Drug Resistance in Major Regions of Russia. Curr HIV Res 2023; 21:347-353. [PMID: 38058095 DOI: 10.2174/011570162x271430231201075335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Revised: 10/04/2023] [Accepted: 10/31/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE The study aimed to compare the prevalence of surveillance HIV drug resistance mutations (SDRMs) across the main federal districts of Russia. METHODS A pooled analysis was conducted to examine data on HIV primary drug resistance (HIV PrimDR). The analysis was based on published results primarily from Russian regional clinical and scientific laboratories, covering a span of 20 years. RESULTS The findings indicate that three surveyed regions, namely Central, Far Eastern, and Volga, exhibit a low level of HIV PrimDR prevalence (not exceeding 5%), and this prevalence does not show a tendency to increase. In contrast, three major regions, namely Northwestern, Southern, and Siberian, demonstrate a significant and progressive increase in HIV PrimDR prevalence, with recent values surpassing 10%. CONCLUSION Consequently, it was concluded that a change in the HIV treatment strategy in these regions is imperative, emphasizing the need to expedite the transition to the utilization of secondgeneration integrase inhibitors.
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Affiliation(s)
- Dmitry Kireev
- Laboratory for Diagnosis and Molecular Epidemiology of HIV, Central Research Institute of Epidemiology, Novogireevskaya Street, 3a, Russia
| | - Alina Kirichenko
- Laboratory for Diagnosis and Molecular Epidemiology of HIV, Central Research Institute of Epidemiology, Novogireevskaya Street, 3a, Russia
| | - Aleksey Lebedev
- Lentiviruses Biology laboratory, Research Institute of Vaccines and Sera. Mechnikov of the Russian Academy of Medical Sciences, Maly Kazenny Lane, 5a, Russia
| | - Marina Bobkova
- Lentiviruses Biology laboratory, Research Institute of Vaccines and Sera. Mechnikov of the Russian Academy of Medical Sciences, Maly Kazenny Lane, 5a, Russia
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Sivay MV, Maksimenko LV, Osipova IP, Nefedova AA, Gashnikova MP, Zyryanova DP, Ekushov VE, Totmenin AV, Nalimova TM, Ivlev VV, Kapustin DV, Pozdnyakova LL, Skudarnov SE, Ostapova TS, Yaschenko SV, Nazarova OI, Chernov AS, Ismailova TN, Maksutov RA, Gashnikova NM. Spatiotemporal dynamics of HIV-1 CRF63_02A6 sub-epidemic. Front Microbiol 2022; 13:946787. [PMID: 36118194 PMCID: PMC9470837 DOI: 10.3389/fmicb.2022.946787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/19/2022] [Indexed: 11/13/2022] Open
Abstract
HIV-1 epidemic in Russia is one of the fastest growing in the world reaching 1.14 million people living with HIV-1 (PLWH) in 2021. Since mid-1990s, the HIV-1 epidemic in Russia has started to grow substantially due to the multiple HIV-1 outbreaks among persons who inject drugs (PWID) leading to expansion of the HIV-1 sub-subtype A6 (former Soviet Union (FSU) subtype A). In 2006, a local HIV-1 sub-epidemic caused by the distribution of novel genetic lineage CRF63_02A6 was identified in Siberia. In this study, we used a comprehensive dataset of CRF63_02A6 pol gene sequences to investigate the spatiotemporal dynamic of the HIV-1 CRF63_02A6 sub-epidemic. This study includes all the available CRF63_02A6 HIV-1 pol gene sequences from Los Alamos National Laboratory (LANL) HIV Sequence Database. The HIV-1 subtypes of those sequences were conferred using phylogenetic analysis, and two automated HIV-1 subtyping tools Stanford HIVdb Program and COMET. Ancestral state reconstruction and origin date were estimated using Nextstrain. Evolutionary rate and phylodynamic analysis were estimated using BEAST v 1.10.4. CRF63_02A6 was assigned for 872 pol gene sequences using phylogenetic analysis approach. Predominant number (n = 832; 95.4%) of those sequences were from Russia; the remaining 40 (4.6%) sequences were from countries of Central Asia. Out of 872 CRF63_02A6 sequences, the corresponding genetic variant was assigned for 75.7 and 79.8% of sequences by Stanford and COMET subtyping tools, respectively. Dated phylogenetic analysis of the CRF63_02A6 sequences showed that the virus most likely originated in Novosibirsk, Russia, in 2005. Over the last two decades CRF63_02A6 has been widely distributed across Russia and has been sporadically detected in countries of Central Asia. Introduction of new genetic variant into mature sub-subtype A6 and CRF02_AGFSU epidemics could promote the increase of viral genetic diversity and emergence of new recombinant forms. Further HIV-1 studies are needed due to a continuing rapid virus distribution. Also, the implementation of HIV-1 prevention programs is required to reduce HIV-1 transmission. This study also highlights the discrepancies in HIV-1 subtyping approaches. The reference lists of HIV-1 sequences implemented in widely used HIV-1 automated subtyping tools need to be updated to provide reliable results.
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Affiliation(s)
- Mariya V. Sivay
- Department of Retroviruses, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
- *Correspondence: Mariya V. Sivay, ;
| | - Lada V. Maksimenko
- Department of Retroviruses, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
| | - Irina P. Osipova
- Department of Retroviruses, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
| | - Anastasiya A. Nefedova
- Department of Retroviruses, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
| | - Mariya P. Gashnikova
- Department of Retroviruses, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
| | - Dariya P. Zyryanova
- Department of Retroviruses, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
| | - Vasiliy E. Ekushov
- Department of Retroviruses, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
| | - Alexei V. Totmenin
- Department of Retroviruses, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
| | - Tatyana M. Nalimova
- Department of Retroviruses, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
| | - Vladimir V. Ivlev
- Department of Retroviruses, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
| | | | | | - Sergey E. Skudarnov
- Krasnoyarsk Regional Center for Prevention and Control of AIDS, Krasnoyarsk, Russia
| | - Tatyana S. Ostapova
- Krasnoyarsk Regional Center for Prevention and Control of AIDS, Krasnoyarsk, Russia
| | | | - Olga I. Nazarova
- Omsk City Center of Prevention and Control of AIDS and Other Infectious Diseases, Omsk, Russia
| | - Aleksander S. Chernov
- Tomsk Regional Center for Prevention and Control of AIDS and Other Infectious Diseases, Tomsk, Russia
| | - Tatyana N. Ismailova
- Tomsk Regional Center for Prevention and Control of AIDS and Other Infectious Diseases, Tomsk, Russia
| | - Rinat A. Maksutov
- Department of Retroviruses, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
| | - Natalya M. Gashnikova
- Department of Retroviruses, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
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Rudometova NB, Shcherbakova NS, Shcherbakov DN, Mishenova EV, Delgado E, Ilyichev AA, Karpenko LI, Thomson MM. Genetic Diversity and Drug Resistance Mutations in Reverse Transcriptase and Protease Genes of HIV-1 Isolates from Southwestern Siberia. AIDS Res Hum Retroviruses 2021; 37:716-723. [PMID: 33677988 DOI: 10.1089/aid.2020.0225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
The analysis of a pol gene fragment encoding protease and part of reverse transcriptase was carried out for 55 sera collected in 2016 and 2018 from HIV-1-infected patients diagnosed in 2014-2018 living in the south of Western Siberia, Russia: Altai Territory (n = 11), Republic of Altai (n = 15), Kemerovo region (n = 18), and Novosibirsk region (n = 11). CRF63_02A was the dominant genetic form (>70%) in the Altai Territory and Kemerovo and Novosibirsk regions, with subsubtype A6 comprising <30% of samples. In the Altai Republic, subsubtype A6 was predominant (53%), with 33% of viruses belonging to CRF63_02A. Four CRF63_02A/A6 unique recombinant forms were identified in the Altai Territory, Kemerovo Region, and the Altai Republic. A majority (11 of 15) of CRF63_02A viruses from Kemerovo were grouped in a cluster. Antiretroviral (ARV) drug resistance mutations were found in 6 (14%) of 43 drug-naive patients. This study provides new insights in HIV-1 molecular epidemiology and prevalence of transmitted ARV drug resistance mutations in Southwestern Siberia.
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Affiliation(s)
- Nadezhda B. Rudometova
- Department of Bioengineering, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
| | - Nadezhda S. Shcherbakova
- Department of Bioengineering, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
| | - Dmitry N. Shcherbakov
- Department of Bioengineering, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
| | - Elena V. Mishenova
- Budgetary Health Care Institution of the Republic of Altai “Center for the Prevention and Control of AIDS”, Gorno-Altaysk, Russia
| | - Elena Delgado
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Alexander A. Ilyichev
- Department of Bioengineering, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
| | - Larisa I. Karpenko
- Department of Bioengineering, State Research Center of Virology and Biotechnology “Vector”, Koltsovo, Russia
| | - Michael M. Thomson
- HIV Biology and Variability Unit, Centro Nacional de Microbiología, Instituto de Salud Carlos III, Madrid, Spain
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