Abstract
The prevalence of drug resistant HIV strains among HIV-positive reproductive aged persons with ineffective antiretroviral therapy (ART) was assessed. The prevalence of drug resistant strains of HIV was 73.8% in the group of women and 89.29% in the group of men (totally in 80.0% of patients). In the spectrum of drug resistance mutations (DRMs) the most prevalent mutation associated with high-level resistance to nucleoside reverse transcriptase inhibitors was substitution M184V (80.36%); in addition, the high prevalence of K65R (26.79%) was indicated. The most common mutations causing a high-level resistance to nonnucleoside reverse transcriptase inhibitors were G190S/A (57.14%), Y181C (37.50%), K101E (33.93%). The DRMs to protease inhibitors were indicated with significantly less frequent (5.36%).
Highlights
Antibiotic and antiretroviral resistance has become a major clinical and public health problem nowadays
HIV resistance is developing as a result of forming of specific mutations in the HIV genome, which lead to changes of amino acids structure of viral proteins – targets of antiretroviral drugs (ARVs)
The test-systems, what were used in that work, allow determining the drug resistance mutations (DRMs) to three classes of ARVs, which are used in Ukraine: to NRTIs, NNRTIs, and PIs
Summary
Antibiotic and antiretroviral resistance has become a major clinical and public health problem nowadays. Strong pressure of civilization as a whole lead to the activation of pathogens genetic variability, the emergence of new pathogens and fast evolution of existing ones. Biological properties of HIV – fast reproduction of new viral particles, high level of genetic variability connected to features of the reverse transcription, archiving of all variants of HIV genoms as proviral DNAs, high probability of genetic recombination – are the factors, which determine fast evolution of viral population and replacement of wild viruses on resistant strains under selective pressure of suboptimal concentrations of ARVs. Consequences of HIV resistance development are the growing of risk of drug resistant HIV strains spreading, the appearing of the necessity of switch to more expensive second- and third-line regimens, the loss of ART and prophylaxis effectiveness. Considering that, the spreading of drug resistant HIV strains among reproductive aged people can lead to the growing of the HIVinfection incidence
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