Molecular Epidemiology of HIV-1 in Eastern Europe and Russia

Viruses. 2022 Sep 22;14(10):2099. doi: 10.3390/v14102099.

Abstract

The HIV epidemic in Eastern Europe and Russia is large and not well-controlled. To describe the more recent molecular epidemiology of HIV-1, transmitted drug resistance, and the relationship between the epidemics in this region, we sequenced the protease and reverse transcriptase genes of HIV-1 from 812 people living with HIV from Ukraine (n = 191), Georgia (n = 201), and Russia (n = 420) before the initiation of antiretroviral therapy. In 190 Ukrainian patients, the integrase gene sequence was also determined. The most reported route of transmission was heterosexual contact, followed by intravenous drug use, and men having sex with men (MSM). Several pre-existing drug resistance mutations were found against non-nucleoside reverse transcriptase inhibitors (RTIs) (n = 103), protease inhibitors (n = 11), and nucleoside analogue RTIs (n = 12), mostly polymorphic mutations or revertants. In the integrase gene, four strains with accessory integrase strand transfer inhibitor mutations were identified. Sub-subtype A6 caused most of the infections (713/812; 87.8%) in all three countries, including in MSM. In contrast to earlier studies, no clear clusters related to the route of transmission were identified, indicating that, within the region, the exchange of viruses among the different risk groups may occur more often than earlier reported.

Keywords: Eastern Europe; HIV-1 sub-subtype A6; epidemiology; phylogeny; pre-existing drug resistance mutations; unique recombinant forms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Drug Resistance, Viral / genetics
  • Europe, Eastern / epidemiology
  • HIV Infections* / drug therapy
  • HIV Infections* / epidemiology
  • HIV Seropositivity*
  • HIV-1* / genetics
  • Homosexuality, Male
  • Humans
  • Integrases / genetics
  • Male
  • Molecular Epidemiology
  • Mutation
  • Nucleosides / therapeutic use
  • Peptide Hydrolases / genetics
  • Phylogeny
  • Protease Inhibitors / therapeutic use
  • RNA-Directed DNA Polymerase / genetics
  • Reverse Transcriptase Inhibitors / therapeutic use
  • Sexual and Gender Minorities*

Substances

  • Reverse Transcriptase Inhibitors
  • Nucleosides
  • Protease Inhibitors
  • RNA-Directed DNA Polymerase
  • Integrases
  • Peptide Hydrolases

Grants and funding

This article/publication is based upon work from CARE Consortium, which received funding from the European Union’s Horizon 2020 Research and Innovation programme under grant agreement no. 825673, by a grant from Russian Science Foundation (project no. 22-15-00117, https://rscf.ru/project/22-15-00117), from the Swedish Research Council (2020-02129), Stockholm County Council (FoUI-955284), and grants from MSD: Grant ID: # INT-20-129627. The study CO-IT-985-6323—EuResist entitled “HIV resistance, molecular epidemiology and new treatment strategies in the eastern European region and in Russia”, promoted and designed by EuResist Network, was conducted under the direction of Dr. Francesca Incardona as Principal Investigator with the support of Gilead Sciences Inc.