Analysis of HIV-1 drug resistance prevalence to protease and reverse transcriptase inhibitors in several territories of the Far Eastern Federal District during 2021–2024

The aim : to perform surveillance over HIV-1 drug resistance mutations among people living with HIV without history of antiretroviral therapy as well as among those receiving antiretroviral treatment and residing in different territories of the Far Eastern Federal district. Materials and methods . A total number of 420 patients diagnosed with HIV-infection and residing in 8 constituent entities of the Far Eastern Federal district were examined. «AmpliSense® HIV-Resist-Seq» kit was used to perform sequencing of the amplified fragments of HIV-1 pol-gene coding protease and a part of reverse transcriptase to detect drug resistance mutations. Stanford University HIVdb Program was employed to retrieve information on drug-resistance mutations. Results and discussion : sub-subtype A6, which is prevalent in Russia, was also dominant in the surveyed group of patients and was isolated in 282 cases (67.1%). A total number of 49 samples were typed as subtype B (11.7%), 12 samples as subtype C (2.9%), 4 samples as subtype G (1.0%). Subtype A7 (0.2%) was detected in one patient from the Republic of Sakha (Yakutia). Different recombinant forms of the virus were identified in 72 patients (17.1%). Percentage of recombinant forms derived from subtypes A and G totaled 80.6% (n=58). Surveillance drug resistance mutations were revealed in 108 out of 248 patients undergoing antiretroviral treatment (43.5%) and in 6 out of 172 treatment-naïve patients (3.5%). Drug resistance to non-nucleoside inhibitors of reverse transcriptase drugs was most common in both treatment naïve patients and those with a prior experience of antiretroviral therapy. Conclusion : regular surveillance of acquired drug resistance provides insight into the effectiveness of HIV prevention and treatment programs in the constituent entities of the Russian Federation and will allow the development of recommendations for treatment strategies.