Patterns of HIV-1 drug resistance among HIV-infected patients receiving first-line antiretroviral therapy in Novosibirsk Region, Russia

• Published in: Journal of global antimicrobial resistance. Vol. 35; pp. 1 - 5
• Main Authors: Kapustin, Dmitriy V., Nalimova, Tatiana M., Ekushov, Vasiliy E., Kriklivaya, Nadezhda P., Halikov, Maksim R., Krasnova, Elena I., Khokhlova, Natalya I., Demchenko, Svetlana V., Pozdnaykova, Larisa L., Sivay, Mariya V., Totmenin, Alexei V., Gashnikova, Mariya P., Gotfrid, Ludmila G., Maksutov, Rinat A., Gashnikova, Natalya M.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01.12.2023; Elsevier
• Subjects: Anti-HIV Agents - pharmacology; Anti-HIV Agents - therapeutic use; Drug resistance; Genetic barrier to antiretroviral therapy; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV-1; HIV-1 - genetics; Humans; Male; Mutation; Russia; Russia - epidemiology; Therapy adherence; Russia; HIV-1; Drug resistance; Therapy adherence; Genetic barrier to antiretroviral therapy; Russia
• ISSN: 2213-7165; 2213-7173
• DOI: 10.1016/j.jgar.2023.07.013

•HIV-related data of patients who failed first-line ART were analysed.•Suboptimal ART adherence was identified in 48.3% of study patients.•54.6% of patients had HIV-1 drug resistance mutations.•DTG and LPV/r-based regimens had high genetic barrier to resistance. Antiretroviral (ARV) drugs have played a vital role in controlling the HIV-1 epidemic; however, some challenges remain. ARV drugs vary in their ability to control HIV infection, displaying differences in treatment-limiting factors and genetic barriers to resistance. The current report assesses the prevalence of HIV-1 drug resistance mutations (DRMs) among patients who failed first-line antiretroviral therapy (ART) and evaluates the genetic barrier of different regimens. The study cohort (n = 271) included HIV-infected individuals who visited the Novosibirsk, Russia, HIV/AIDS clinic in 2018–2022. All patients received first-line ART prior to virological failure. Sociodemographic and HIV-related data were collected from medical records and self-reported questionnaires. HIV-1 pol gene sequences were generated, and the presence of HIV-1 DRM was assessed. The genetic barrier to resistance was assessed by combining treatment regimen and adherence data. Nonoptimal ART adherence was identified in 48.3% of patients and correlated with male sex, PWID, unemployment, and rural area residence. Most of the patients with high-level adherence were identified among those who were on TDF+3TC+DTG. HIV-1 DRMs were identified in 54.6% of the patients. The analysis of HIV-1 DRM, ART regimen, and adherence data classified TDF+3TC+DTG and TDF+3TC+LPV/r as treatment regimens with a high genetic barrier, whereas EFV-containing ART was classified as a regimen with a low genetic barrier. The current study delivers results on the efficacy of HIV-1 ART and treatment adherence in real-world practice settings. This report suggests that ART regimens with a high genetic barrier to resistance combined with improved treatment adherence may reduce the transmission of HIV-1 resistant variants.