Cargando…
Prevalence of HIV-1 drug resistance in Eastern European and Central Asian countries
BACKGROUND: Eastern Europe and Central Asia (EECA) is one of the regions where the HIV epidemic continues to grow at a concerning rate. Antiretroviral therapy (ART) coverage in EECA countries has significantly increased during the last decade, which can lead to an increase in the risk of emergence,...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8782385/ https://www.ncbi.nlm.nih.gov/pubmed/35061671 http://dx.doi.org/10.1371/journal.pone.0257731 |
_version_ | 1784638303131140096 |
---|---|
author | Kirichenko, Alina Kireev, Dmitry Lopatukhin, Alexey Murzakova, Anastasia Lapovok, Ilya Saleeva, Daria Ladnaya, Natalya Gadirova, Agigat Ibrahimova, Sabina Safarova, Aygun Grigoryan, Trdat Petrosyan, Arshak Sarhatyan, Tatevik Gasich, Elena Bunas, Anastasia Glinskaya, Iryna Yurovsky, Pavel Nurov, Rustam Soliev, Alijon Ismatova, Laylo Musabaev, Erkin Kazakova, Evgeniya Rakhimova, Visola Pokrovsky, Vadim |
author_facet | Kirichenko, Alina Kireev, Dmitry Lopatukhin, Alexey Murzakova, Anastasia Lapovok, Ilya Saleeva, Daria Ladnaya, Natalya Gadirova, Agigat Ibrahimova, Sabina Safarova, Aygun Grigoryan, Trdat Petrosyan, Arshak Sarhatyan, Tatevik Gasich, Elena Bunas, Anastasia Glinskaya, Iryna Yurovsky, Pavel Nurov, Rustam Soliev, Alijon Ismatova, Laylo Musabaev, Erkin Kazakova, Evgeniya Rakhimova, Visola Pokrovsky, Vadim |
author_sort | Kirichenko, Alina |
collection | PubMed |
description | BACKGROUND: Eastern Europe and Central Asia (EECA) is one of the regions where the HIV epidemic continues to grow at a concerning rate. Antiretroviral therapy (ART) coverage in EECA countries has significantly increased during the last decade, which can lead to an increase in the risk of emergence, transmission, and spread of HIV variants with drug resistance (DR) that cannot be controlled. Because HIV genotyping cannot be performed in these countries, data about HIV DR are limited or unavailable. OBJECTIVES: To monitor circulating HIV-1 genetic variants, assess the prevalence of HIV DR among patients starting antiretroviral therapy, and reveal potential transmission clusters among patients in six EECA countries: Armenia, Azerbaijan, Belarus, Russia, Tajikistan, and Uzbekistan. MATERIALS AND METHODS: We analyzed 1071 HIV-1 pol-gene fragment sequences (2253–3369 bp) from patients who were initiating or reinitiating first-line ART in six EECA counties, i.e., Armenia (n = 120), Azerbaijan (n = 96), Belarus (n = 158), Russia (n = 465), Tajikistan (n = 54), and Uzbekistan (n = 178), between 2017 and 2019. HIV Pretreatment DR (PDR) and drug resistance mutation (DRM) prevalence was estimated using the Stanford HIV Resistance Database. The PDR level was interpreted according to the WHO standard PDR survey protocols. HIV-1 subtypes were determined using the Stanford HIV Resistance Database and subsequently confirmed by phylogenetic analysis. Transmission clusters were determined using Cluster Picker. RESULTS: Analyses of HIV subtypes showed that EECA, in general, has the same HIV genetic variants of sub-subtype A6, CRF63_02A1, and subtype B, with different frequencies and representation for each country. The prevalence of PDR to any drug class was 2.8% in Uzbekistan, 4.2% in Azerbaijan, 4.5% in Russia, 9.2% in Armenia, 13.9% in Belarus, and 16.7% in Tajikistan. PDR to protease inhibitors (PIs) was not detected in any country. PDR to nucleoside reverse-transcriptase inhibitors (NRTIs) was not detected among patients in Azerbaijan, and was relatively low in other countries, with the highest prevalence in Tajikistan (5.6%). The prevalence of PDR to nonnucleoside reverse-transcriptase inhibitors (NNRTIs) was the lowest in Uzbekistan (2.8%) and reached 11.1% and 11.4% in Tajikistan and Belarus, respectively. Genetic transmission network analyses identified 226/1071 (21.1%) linked individuals, forming 93 transmission clusters mainly containing two or three sequences. We found that the time since HIV diagnosis in clustered patients was significantly shorter than that in unclustered patients (1.26 years vs 2.74 years). Additionally, the K103N/S mutation was mainly observed in clustered sequences (6.2% vs 2.8%). CONCLUSIONS: Our study demonstrated different PDR prevalence rates and DR dynamics in six EECA countries, with worrying levels of PDR in Tajikistan and Belarus, where prevalence exceeded the 10% threshold recommended by the WHO for immediate public health action. Because DR testing for clinical purposes is not common in EECA, it is currently extremely important to conduct surveillance of HIV DR in EECA due to the increased ART coverage in this region. |
format | Online Article Text |
id | pubmed-8782385 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-87823852022-01-22 Prevalence of HIV-1 drug resistance in Eastern European and Central Asian countries Kirichenko, Alina Kireev, Dmitry Lopatukhin, Alexey Murzakova, Anastasia Lapovok, Ilya Saleeva, Daria Ladnaya, Natalya Gadirova, Agigat Ibrahimova, Sabina Safarova, Aygun Grigoryan, Trdat Petrosyan, Arshak Sarhatyan, Tatevik Gasich, Elena Bunas, Anastasia Glinskaya, Iryna Yurovsky, Pavel Nurov, Rustam Soliev, Alijon Ismatova, Laylo Musabaev, Erkin Kazakova, Evgeniya Rakhimova, Visola Pokrovsky, Vadim PLoS One Research Article BACKGROUND: Eastern Europe and Central Asia (EECA) is one of the regions where the HIV epidemic continues to grow at a concerning rate. Antiretroviral therapy (ART) coverage in EECA countries has significantly increased during the last decade, which can lead to an increase in the risk of emergence, transmission, and spread of HIV variants with drug resistance (DR) that cannot be controlled. Because HIV genotyping cannot be performed in these countries, data about HIV DR are limited or unavailable. OBJECTIVES: To monitor circulating HIV-1 genetic variants, assess the prevalence of HIV DR among patients starting antiretroviral therapy, and reveal potential transmission clusters among patients in six EECA countries: Armenia, Azerbaijan, Belarus, Russia, Tajikistan, and Uzbekistan. MATERIALS AND METHODS: We analyzed 1071 HIV-1 pol-gene fragment sequences (2253–3369 bp) from patients who were initiating or reinitiating first-line ART in six EECA counties, i.e., Armenia (n = 120), Azerbaijan (n = 96), Belarus (n = 158), Russia (n = 465), Tajikistan (n = 54), and Uzbekistan (n = 178), between 2017 and 2019. HIV Pretreatment DR (PDR) and drug resistance mutation (DRM) prevalence was estimated using the Stanford HIV Resistance Database. The PDR level was interpreted according to the WHO standard PDR survey protocols. HIV-1 subtypes were determined using the Stanford HIV Resistance Database and subsequently confirmed by phylogenetic analysis. Transmission clusters were determined using Cluster Picker. RESULTS: Analyses of HIV subtypes showed that EECA, in general, has the same HIV genetic variants of sub-subtype A6, CRF63_02A1, and subtype B, with different frequencies and representation for each country. The prevalence of PDR to any drug class was 2.8% in Uzbekistan, 4.2% in Azerbaijan, 4.5% in Russia, 9.2% in Armenia, 13.9% in Belarus, and 16.7% in Tajikistan. PDR to protease inhibitors (PIs) was not detected in any country. PDR to nucleoside reverse-transcriptase inhibitors (NRTIs) was not detected among patients in Azerbaijan, and was relatively low in other countries, with the highest prevalence in Tajikistan (5.6%). The prevalence of PDR to nonnucleoside reverse-transcriptase inhibitors (NNRTIs) was the lowest in Uzbekistan (2.8%) and reached 11.1% and 11.4% in Tajikistan and Belarus, respectively. Genetic transmission network analyses identified 226/1071 (21.1%) linked individuals, forming 93 transmission clusters mainly containing two or three sequences. We found that the time since HIV diagnosis in clustered patients was significantly shorter than that in unclustered patients (1.26 years vs 2.74 years). Additionally, the K103N/S mutation was mainly observed in clustered sequences (6.2% vs 2.8%). CONCLUSIONS: Our study demonstrated different PDR prevalence rates and DR dynamics in six EECA countries, with worrying levels of PDR in Tajikistan and Belarus, where prevalence exceeded the 10% threshold recommended by the WHO for immediate public health action. Because DR testing for clinical purposes is not common in EECA, it is currently extremely important to conduct surveillance of HIV DR in EECA due to the increased ART coverage in this region. Public Library of Science 2022-01-21 /pmc/articles/PMC8782385/ /pubmed/35061671 http://dx.doi.org/10.1371/journal.pone.0257731 Text en © 2022 Kirichenko et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Kirichenko, Alina Kireev, Dmitry Lopatukhin, Alexey Murzakova, Anastasia Lapovok, Ilya Saleeva, Daria Ladnaya, Natalya Gadirova, Agigat Ibrahimova, Sabina Safarova, Aygun Grigoryan, Trdat Petrosyan, Arshak Sarhatyan, Tatevik Gasich, Elena Bunas, Anastasia Glinskaya, Iryna Yurovsky, Pavel Nurov, Rustam Soliev, Alijon Ismatova, Laylo Musabaev, Erkin Kazakova, Evgeniya Rakhimova, Visola Pokrovsky, Vadim Prevalence of HIV-1 drug resistance in Eastern European and Central Asian countries |
title | Prevalence of HIV-1 drug resistance in Eastern European and Central Asian countries |
title_full | Prevalence of HIV-1 drug resistance in Eastern European and Central Asian countries |
title_fullStr | Prevalence of HIV-1 drug resistance in Eastern European and Central Asian countries |
title_full_unstemmed | Prevalence of HIV-1 drug resistance in Eastern European and Central Asian countries |
title_short | Prevalence of HIV-1 drug resistance in Eastern European and Central Asian countries |
title_sort | prevalence of hiv-1 drug resistance in eastern european and central asian countries |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8782385/ https://www.ncbi.nlm.nih.gov/pubmed/35061671 http://dx.doi.org/10.1371/journal.pone.0257731 |
work_keys_str_mv | AT kirichenkoalina prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT kireevdmitry prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT lopatukhinalexey prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT murzakovaanastasia prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT lapovokilya prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT saleevadaria prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT ladnayanatalya prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT gadirovaagigat prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT ibrahimovasabina prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT safarovaaygun prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT grigoryantrdat prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT petrosyanarshak prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT sarhatyantatevik prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT gasichelena prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT bunasanastasia prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT glinskayairyna prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT yurovskypavel prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT nurovrustam prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT solievalijon prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT ismatovalaylo prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT musabaeverkin prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT kazakovaevgeniya prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT rakhimovavisola prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries AT pokrovskyvadim prevalenceofhiv1drugresistanceineasterneuropeanandcentralasiancountries |