Central Research Institute of Epidemiology, 111123 Moscow, Russia.
Department of Infectious Diseases with Courses of Epidemiology and Phthisiology, Medical Institute, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia.
Viruses. 2023 Apr 18;15(4):991. doi: 10.3390/v15040991.
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.
在俄罗斯，抗逆转录病毒疗法（ART）的覆盖率显著提高，但由于缺乏常规的基因分型检测，可能会导致 HIV 耐药性（DR）的增加。本研究旨在调查 2006 年至 2022 年期间，使用来自俄罗斯数据库（4481 个蛋白酶和逆转录酶以及 844 个整合酶基因序列）的治疗初治患者的 HIV 耐药模式和时间趋势以及遗传变异的流行情况。使用斯坦福数据库确定 HIV 遗传变异和耐药性和耐药突变（DRMs）。分析显示病毒多样性很高，A6 占主导地位（78.4%），在所有传播风险组中最为常见。监测耐药突变（SDRMs）的总体流行率为 5.4%，在 2022 年达到 10.0%。大多数患者携带 NNRTI SDRMs（3.3%）。SDRMs 的流行率在乌拉尔地区最高（7.9%）。男性性别和 CRF63_02A6 变异是与 SDRMs 相关的因素。DR 的总体流行率为 12.7%，并随时间增加，主要是由于 NNRTIs。由于俄罗斯缺乏基线 HIV 基因分型，因此需要对 HIV DR 进行监测，因为 ART 的覆盖率和 DR 的流行率都有所增加。在国家数据库中集中收集和统一分析所有收到的基因型有助于了解 DR 的模式和趋势，从而改进治疗方案并提高 ART 的效果。此外，使用国家数据库可以帮助确定具有高 HIV DR 流行率的地区或传播风险组，以便采取流行病学措施防止 HIV DR 在该国传播。
