Evolution of HIV-1 Resistance Patients Failing Antiretroviral Therapy in the Republic of Uzbekistan

Relevance. The Republic of Uzbekistan is implementing a national programme to prevent the spread of HIV and expand treatment coverage for HIV-infected residents, HIV resistance testing is being introduced into clinical practice for the first time at the Republican AIDS Centre.

The aim of the study is to investigate the prevalence of HIV-1 mutations associated with viral resistance to antiretroviral drugs among residents who have failed therapy.

Materials and methods. HIV-1 resistance development was performed for 194 patients with registered virological treatment failure. The nucleotide sequences of the pol gene encoding HIV-1 protease and reverse transcriptase were obtained by sequencing amplified fragments of the virus. Mutational analysis was performed using specialized software.

Results and discussion. In 42.3% of cases HIV-1 did not have any resistance mutations, which indicates low patient adherence to treatment or covert rejection of therapy. HIV-1 resistance mutations were detected in 112 of the 194 samples (57.7%); mutations to two classes of drugs were found in 59.8% of cases, in 3.6% to three classes. Of the 112 patients 66 had HIV RNA concentrations in their blood exceeding 50,000 copies/ml, and the viruses isolated from them had medium and high levels of resistance to ART drugs, which creates the conditions for the transmission of resistant viruses.

Conclusion. The introduction of HIV resistance testing into clinical practice is a key measure in the comprehensive program to combat the epidemic, aimed at resolving the problem of the emergence and spread of drug-resistant strains of HIV-1 in the country.

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