HIV MOLECULAR EPIDEMIOLOGY AND PHARMACO-RESISTANCE IN PATIENTS WITH ANTIRETROVIRAL THERAPY FAILURE IN ARKHANGELSK DISTRICT

Abstract

Introduction . The HIV epidemic remains the most devastating in the history of mankind, despite comprehensive preventive measures. The HIV pharmacological resistance to several groups drugs at once is particular importance since this significantly reduces the therapy possibilities. Due to the low adherence to the treatment of patients certain categories, as well as the HIV drug-resistant transmission under various conditions possibility, treatment may not give positive results in 16–27% of patients who did not receive ART and in 50–70% of previously treated patients. The aim of our work was to evaluate the molecular-epidemiological structure and pharmacoresistant HIV variants in patients with antiretroviral therapy virologic failure in Arkhangelsk. Materials and methods. To evaluate the molecular-epidemiological structure and pharmacoresistant HIV variants in 76 HIV-infected patients with virologic failure of antiretroviral therapy from the Arkhangelsk region, HIV polymerase gene ( pol ) nucleotide sequences were analyzed. Results. In the examined group, HIV subtype A6 (IDU-A) prevailed (89,5%) compared with subtype B (9,2%), in one case (1,3%) the variant CRF03_AB was detected. For 86,8% of patients, resistance to any drugs was determined. Including resistance to protease inhibitors mutations — 33,3%, to revertase inhibitors — 92,4%. Isolates with pharmacoresistance only to NRTIs amounted to 16,6%, to NNRTIs 1,5%, to PI 10,6%, simultaneously to PI and NRTIs 12,1%, to NRTIs and NNRTIs 46,96%, to all three groups of drugs at the same time — 12,1%. The most common mutations are drug resistance to lamivudine and emtricitabine (M184V), nevirapine and efavirenze (K103N, G190S), thymidine analogs (T215F/Y and/or K219Q/E and/or D67N), and non-thymidine L nucleoside analogues).