# HIV-1 Genetic Diversity and Drug Resistance Mutation Profiles in Donetsk, Luhansk and Zaporizhzhia Regions

## TL;DR

This study examines HIV-1 genetic diversity and drug resistance in three Ukrainian regions, finding moderate resistance levels and highlighting the need for ongoing monitoring.

## Contribution

The study provides new insights into HIV-1 resistance mutation profiles and genetic diversity in Donetsk, Luhansk, and Zaporizhzhia.

## Key findings

- The overall prevalence of drug resistance mutations to INSTIs was 3.6%.
- G140R and Y143R were the most common major drug resistance mutations.
- High-level resistance was observed for RAL (57.1%) and CAB (42.9%).

## Abstract

The first major HIV outbreak in the Eastern Europe and Central Asia (EECA) region was registered. Phylogeographic analysis revealed that the main exporters of the virus were Donetsk and Lugansk, from which most migration events occurred, and the predominant genetic variant in Donetsk was subtype A. However, despite a relatively high level of understanding of HIV genetic diversity, data on resistance mutations remain limited. The aim of this study is to assess HIV genetic diversity and drug resistance in Donetsk, Luhansk and Zaporizhzhia regions. A comprehensive examination was conducted, encompassing 392 sequences covering the integrase-coding region of the HIV-1 pol gene. Subtyping was achieved through various programs, including COMET, the Stanford Database, BLAST and REGA. The study also involved phylogenetic analysis to clarify HIV genovariants. The profiles and levels of drug resistance were determined. The overall prevalence of drug resistance mutations to the integrase strand transfer inhibitors (INSTIs) among the studied patients was 3.6% (95% CI, 1.7–5.4%). The most commonly detected major DRMs for INSTIs were G140R (4, 28.6%) and Y143R (3, 21.4%), followed by R263K (2, 14.3%), G140RG (2, 14.3%), Y143YS (2, 14.3%), Y143YC (1, 7.1%) and Q148QR (1, 7.1%). A high-level resistance was observed for RAL—8/14 (57.1%), CAB—6/14 (42.9%) and EVG—2/14 (14.3%). The results presented are part of a further larger study and are preliminary. The results of this study suggest a moderate HIV-1 resistance situation in the Donetsk, Luhansk and Zaporizhzhia regions, but require further monitoring.