Speaker
Description
For the past decade, incidence of HIV has been on the rise in Eastern Europe and Central Asia, including the former Soviet Union (FSU) countries. Ineffective antiretroviral treatment (ART) administration leads to emergence of drug resistance mutations (DRM) leading to increased viral load. Since people living with HIV (PLWH) with higher viral load are more likely to transmit the infection, it is imperative to optimize the ART prescription to prevent further spread of the virus. For this study, we analyzed 13,283 HIV sequences from FSU countries, including Armenia, Azerbaijan, Estonia, Georgia, Kazakhstan, Kyrgyzstan, Latvia, Lithuania, Moldova, Tajikistan, Ukraine, Uzbekistan, Belarus and Russia. A total of 11,748 and 625 HIV pol sequences belonging to, respectively, subtype A6 and CRF_02AG were retrieved from the Los Alamos HIV sequence database. Additionally, we included 563 A6 and 347 CRF_02AG pol sequences generated in our laboratory from Kazakhstani PLWH. Using the Stanford database, several major and accessory DRM were identified: the most prevalent DRM in A6 were A62V (39%), M184V (18%), G190S (11%), K101E (6%), and D67N (2%). Whereas for the CRF02_AG sequences, the most represented DRM were K103N (22%), M184V (19%), and S68G (9%). In a large number of sequences exhibited combination of multiple DRM known to confer high-level resistance to the currently prescribed ARV drugs. The DRM A62V was predominantly found in Russia, Kazakhstan, and Uzbekistan, whereas the DRM M184V was most frequently observed in Belarus and Ukraine. Phylogenetic analysis revealed a preponderance of the DRM A62V among earlier transmissions of subtype A6 in FSU region, involving multiple countries, whereas the DRM K103N appeared frequently in Kyrgyzstan and Kazakhstan. Our findings provide insight into the origin and transmission of HIV DRM prevalent in the FSU countries, highlighting the importance of optimization of ART regimens to curtail further emergence of DRM in this region.
