Characterization of HIV-1 Epidemic in Kyrgyzstan

Mariya V Sivay; Alexei V Totmenin; Daria P Zyryanova; Irina P Osipova; Tatyana M Nalimova; Mariya P Gashnikova; Vladimir V Ivlev; Ivan O Meshkov; Umut Z Chokmorova; Elmira Narmatova; Ulukbek Motorov; Zhyldyz Akmatova; Nazgul Asybalieva; Aybek A Bekbolotov; Ulan K Kadyrbekov; Rinat A Maksutov; Natalya M Gashnikova

doi:10.3389/fmicb.2021.753675

Characterization of HIV-1 Epidemic in Kyrgyzstan

Front Microbiol. 2021 Oct 15:12:753675. doi: 10.3389/fmicb.2021.753675. eCollection 2021.

Authors

Mariya V Sivay¹, Alexei V Totmenin¹, Daria P Zyryanova¹, Irina P Osipova¹, Tatyana M Nalimova¹, Mariya P Gashnikova¹, Vladimir V Ivlev¹, Ivan O Meshkov², Umut Z Chokmorova³, Elmira Narmatova⁴, Ulukbek Motorov⁴, Zhyldyz Akmatova³, Nazgul Asybalieva³, Aybek A Bekbolotov³, Ulan K Kadyrbekov³, Rinat A Maksutov¹, Natalya M Gashnikova¹

Affiliations

¹ Department of Retroviruses, State Research Center of Virology and Biotechnology "Vector", Koltsovo, Russia.
² National Research Center for Hematology, Moscow, Russia.
³ Republican Center of AIDS, Ministry of Health of Kyrgyzstan, Bishkek, Kyrgyzstan.
⁴ Osh Regional Center of AIDS Treatment and Prevention, Osh, Kyrgyzstan.

Abstract

Kyrgyzstan has one of the highest rates of HIV-1 spread in Central Asia. In this study, we used molecular-epidemiological approaches to examine the HIV-1 epidemic in Kyrgyzstan. Samples were obtained from HIV-positive individuals who visited HIV/AIDS clinics. Partial pol gene sequences were used to identify HIV-1 subtypes and drug resistance mutations (DRMs) and to perform phylogenetic analysis. Genetic diversity and history reconstruction of the major HIV-1 subtypes were explored using BEAST. This study includes an analysis of 555 HIV-positive individuals. The study population was equally represented by men and women aged 1-72 years. Heterosexual transmission was the most frequent, followed by nosocomial infection. Men were more likely to acquire HIV-1 during injection drug use and while getting clinical services, while women were more likely to be infected through sexual contacts (p < 0.01). Heterosexual transmission was the more prevalent among individuals 25-49 years old; individuals over 49 years old were more likely to be persons who inject drugs (PWID). The major HIV-1 variants were CRF02_AG, CRF63_02A, and sub-subtype A6. Major DRMs were detected in 26.9% of the study individuals; 62.2% of those had DRMs to at least two antiretroviral (ARV) drug classes. Phylogenetic analysis revealed a well-defined structure of CRF02_AG, indicating locally evolving sub-epidemics. The lack of well-defined phylogenetic structure was observed for sub-subtype A6. The estimated origin date of CRF02_AG was January 1997; CRF63_02A, April 2004; and A6, June 1995. A rapid evolutionary dynamic of CRF02_AG and A6 among Kyrgyz population since the mid-1990s was observed. We observed the high levels of HIV-1 genetic diversity and drug resistance in the study population. Complex patterns of HIV-1 phylogenetics in Kyrgyzstan were found. This study highlights the importance of molecular-epidemiological analysis for HIV-1 surveillance and treatment implementation to reduce new HIV-1 infections.

Keywords: Central Asia; HIV molecular epidemiology; HIV phylogenetics; Kyrgyzstan; phylodynamic analysis.