32nd International Dynamics & Evolution of Human Viruses

TRANSMISSION CLUSTER ANALYSIS OF DRUG RESISTANCE MUTATIONS IN HIV-1 SUBTYPE A6 IN THE FSU REGION

Not scheduled

20m

Abbaye de Royaumont, Asnières-sur-Oise, France

Poster Transmission dynamics & clusters Virtual posters

Speaker

Anastasiia Nefedova (Nazarbayev University)

Description

The HIV epidemic in the Former Soviet Union (FSU) is growing rapidly, with 140,000 new infections reported in 2023, marking a 20% increase since 2010. Despite ongoing efforts to expand HIV prevention and treatment programs, AIDS-related deaths are on the rise in this region, underscoring the need for a better understanding of transmission dynamics and drug resistance mutations (DRMs) to inform public health strategies. To address these challenges, this study investigated the HIV-1 A6 transmission clusters in the FSU region, aiming to characterize the prevalence and transmission dynamics of drug resistance mutations among key populations. We analyzed 12,295 A6 HIV-1 sequences from the Los Alamos National Laboratory (LANL) database. Additionally, 563 patient sequences were generated in our laboratory using blood samples from people living with HIV in Kazakhstan. Transmission network and phylogenetic analyses were conducted using HIV-TRACE, IQ-TREE, and BEAST. Clusters were annotated with country of origin, resistance level, transmission route, gender, and sampling year. Our analysis identified 624 distinct transmission clusters, including one major cluster with 4,291 samples predominantly of subtype A6, spanning multiple countries. Evidence of DRM transmission was detected, particularly for A62V and M184V mutations, indicating ongoing transmission of drug-resistant strains. Cross-country transmission was identified in multiple clusters. Additionally, clusters with high resistance levels to nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) were identified. These clusters included both antiretroviral therapy (ART)-naive and ART-experienced patients. The presence of large HIV-1 transmission clusters and the ongoing spread of key drug resistance mutations in the FSU region highlight the urgency of targeted interventions. The regional spread of DRMs calls for coordinated international public health efforts to curb the epidemic to mitigate the impact of DRMs on treatment outcomes.