Prevalence of Pretreatment HIV-1 Drug Resistance in Armenia in 2017-2018 and 2020-2021 following a WHO Survey

Alina Kirichenko; Dmitry Kireev; Ilya Lapovok; Anastasia Shlykova; Alexey Lopatukhin; Anastasia Pokrovskaya; Natalya Ladnaya; Trdat Grigoryan; Arshak Petrosyan; Tatevik Sarhatyan; Narina Sargsyants; Tamara Hovsepyan; Hovsep Ghazaryan; Hermine Hovakimyan; Siranush Martoyan; Vadim Pokrovsky

doi:10.3390/v14112320

Prevalence of Pretreatment HIV-1 Drug Resistance in Armenia in 2017-2018 and 2020-2021 following a WHO Survey

Viruses. 2022 Oct 22;14(11):2320. doi: 10.3390/v14112320.

Authors

Alina Kirichenko¹, Dmitry Kireev¹, Ilya Lapovok¹, Anastasia Shlykova¹, Alexey Lopatukhin¹, Anastasia Pokrovskaya^{1

2}, Natalya Ladnaya¹, Trdat Grigoryan³, Arshak Petrosyan³, Tatevik Sarhatyan³, Narina Sargsyants³, Tamara Hovsepyan³, Hovsep Ghazaryan³, Hermine Hovakimyan³, Siranush Martoyan³, Vadim Pokrovsky¹

Affiliations

¹ Central Research Institute of Epidemiology, 111123 Moscow, Russia.
² Department of Infectious Diseases with Courses of Epidemiology and Phthisiology, Medical Institute, Peoples' Friendship University of Russia (RUDN University), 117198 Moscow, Russia.
³ National Center for Infectious Diseases, Yerevan 0025, Armenia.

Abstract

The increased antiretroviral therapy (ART) coverage of patients in the absence of routine genotyping tests and in the context of active labor migration highlight the importance of HIV-1 drug resistance (DR) surveillance in Armenia. We conducted a two-phase pretreatment DR (PDR) study in 2017-2018 (phase I; 120 patients) and 2020-2021 (phase II; 133 patients) according to the WHO-approved protocol. The analysis of HIV-1 genetic variants showed high degrees of viral diversity, with the predominance of A6. The prevalence of any PDR was 9.2% in phase I and 7.5% in phase II. PDR to protease inhibitors was found only in 0.8% in phase II. PDR to efavirenz and nevirapine was found among 5.0% and 6.7% of patients in phase I, and 6.0% and 6.8% of patients in phase II, respectively. The prevalence of PDR to nucleoside reverse-transcriptase inhibitors decreased from 5.0% in phase I to 0.8% in phase II. In addition, we identified risk factors associated with the emergence of DR-male, MSM, subtype B, and residence in or around the capital of Armenia-and showed the active spread of HIV-1 among MSM in transmission clusters, i.e., harboring DR, which requires the immediate attention of public health policymakers for the prevention of HIV-1 DR spread in the country.

Keywords: Armenia; EECA; HIV-1; PDR; drug resistance.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anti-HIV Agents* / pharmacology
Anti-HIV Agents* / therapeutic use
Armenia / epidemiology
Drug Resistance, Viral / genetics
Female
Genotype
HIV Infections* / drug therapy
HIV Infections* / epidemiology
HIV Infections* / prevention & control
HIV Seropositivity*
HIV-1* / genetics
Homosexuality, Male
Humans
Male
Mutation
Pregnancy
Prevalence
Sexual and Gender Minorities*
World Health Organization

Substances

Anti-HIV Agents

Grants and funding

This research study was funded by the Government of the Russian Federation according to No. 2314-r and No. 2656-r executions on providing technical assistance to EECA countries in the fight against the spread of HIV infection in 2016–2018 and 2019–2021.