Practical aspects of human immunodeficiency virus multiresistance in modern clinical practice

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription Access

Abstract

The article presents an analysis of a special clinical case: a male patient with perinatal HIV infection and the development of HIV multi-resistance to antiretroviral drugs. Multiple corrections of treatment regimens were carried out based on the results of determining HIV resistance to the antiretroviral drugs used. The treatment regimen included antiretroviral drugs with fundamentally new mechanisms of action for HIV, not registered in the Russian Federation. However, to date, in the patient with more than twenty years of experience in antiretroviral therapy, it has not been possible to achieve immunological and virological efficacy of treatment. There continues to be a persistent decrease in the indicators of the immune status and an increase in the viral load of HIV in the blood, the appearance of clinical symptoms of opportunistic diseases indicating the progression of HIV infection and an unfavorable vital prognosis, despite the use of various combinations of antiretroviral drugs. This observation demonstrates the difficulties in choosing an effective antiretroviral therapy, taking into account the established sensitivity of HIV to antiretroviral drugs and the possibility of their progredient administration. It is certainly necessary to analyze all ART regimens with the results of HIV resistance to antiretroviral drugs using to improve the effectiveness of therapy is in each case.

About the authors

Dinara R. Nabiullina

Moscow City Centre for AIDS Prevention and Treatment

Email: dinara.nab@gmail.com
ORCID iD: 0000-0003-1862-245X
SPIN-code: 5137-7597

MD

Russian Federation, Moscow

Alexey I. Mazus

Moscow City Centre for AIDS Prevention and Treatment

Author for correspondence.
Email: lettermazus@spid.ru
ORCID iD: 0000-0003-2581-1443
SPIN-code: 1719-4005

MD, Dr. Sci. (Med.)

Russian Federation, Moscow

Natalya G. Litvinova

Moscow City Centre for AIDS Prevention and Treatment

Email: nlitvinova25@mail.ru
ORCID iD: 0000-0003-1257-2594
SPIN-code: 4749-5870

MD

Russian Federation, Moscow

Agunda A. Khamatova

Moscow City Centre for AIDS Prevention and Treatment; Russian Medical Academy of Continuous Professional Education

Email: khamatova_a@mail.ru
ORCID iD: 0000-0002-0312-1380
SPIN-code: 6404-7948

MD

Russian Federation, Moscow; Moscow

Margarita V. Nagibina

Moscow City Centre for AIDS Prevention and Treatment

Email: infektor03@gmail.com
ORCID iD: 0000-0001-5327-9824
SPIN-code: 6779-9405

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Tatyana A. Chebotareva

Russian Medical Academy of Continuous Professional Education

Email: t_sheina@mail.ru
ORCID iD: 0000-0002-6607-3793
SPIN-code: 1053-8790

MD, Dr. Sci. (Med.), Professor

Russian Federation, Moscow

Timur P. Bessarab

Moscow City Centre for AIDS Prevention and Treatment

Email: bessarab@spid.ru
ORCID iD: 0000-0001-6565-7407
SPIN-code: 1859-2381

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

Evgeniy V. Ivannikov

Moscow City Centre for AIDS Prevention and Treatment

Email: patin1961@yandex.ru
ORCID iD: 0000-0003-4981-0824
SPIN-code: 4329-7514

MD

Russian Federation, Moscow

Nikita A. Smirnov

Moscow City Centre for AIDS Prevention and Treatment

Email: came4u@mail.ru
ORCID iD: 0000-0003-4991-3241
SPIN-code: 5508-4101

MD

Russian Federation, Moscow

Victoria S. Mashael

Infectious Diseases Hospital No. 2

Email: v.mashael@mail.ru
ORCID iD: 0000-0001-5444-1918
SPIN-code: 7851-6103

MD

Russian Federation, Moscow

Yulia F. Vlatshkaya

Moscow City Centre for AIDS Prevention and Treatment

Email: dr.vlatskaya@ramler.ru
ORCID iD: 0000-0002-1408-0879
SPIN-code: 6891-2014

MD, Cand. Sci. (Med.)

Russian Federation, Moscow

References

  1. World Health Organization. HIV/AIDS [Internet]. [cited 30 May 2022]. Available from: https://www.who.int/ru/news-room/fact-sheets/detail/hiv-aids.
  2. Nechaeva OB. Impact of HIV infection epidemic in Russia. Medical Alliance. 2019;7(4):6–16. (In Russ.).
  3. Nechaeva OB, Podymova AS. Impact of HIV infection on demographic situation in Russia. Medical Alliance. 2018;(1):6–16. (In Russ.).
  4. Belyakov NA, Ogurtsova SV, Azovtseva OV, et al. Analysis of the main epidemiological indicators of HIV infection and results of multiyear application of antiretroviral therapy (by the materials from the North-West of Russia). Infectious Diseases: News, Opinions, Training. 2020;9(1):19–27. (In Russ.). doi: 10.33029/2305-3496-2020-9-1-19-27
  5. Vostroknutov ME. Analysis of lethal outcomes in patients with HIV/tuberculosis co-infection undergoing inpatient treatment in penitentiaries. Consilium Medicum. 2019;21(3):33–36. (In Russ.). doi: 10.26442/20751753.2019.3.190208
  6. Azovtseva OV, Bogacheva TE, Veber VR, Arkhipov GS. Analysis of general cause of death in HIV-infected patients. HIV Infection and Immunosuppressive Disorders. 2018;10(1):84–91. (In Russ.). doi: 10.22328/2077-9828-2018-10-1-84-91
  7. Bartlett JA, DeMasi R, Quinn J, et al. Overview of the effectiveness of triple combination therapy in antiretroviral-naive HIV-1 infected adults. AIDS. 2001;15(11):1369–1377. doi: 10.1097/00002030-200107270-00006
  8. Oette M, Kaiser R, Däumer M, et al. Primary HIV drug resistance and efficacy of first-line antiretroviral therapy guided by resistance testing. J Acquir Immune Defic Syndr. 2006;41(5):573–581. doi: 10.1097/01.qai.0000214805.52723.c1
  9. Kravchenko AV, Golokhvastova EL, Vinogradova EN, Volova LYu. Highly active antiretroviral therapy in HIV-infected patients who are multidrug HIV resistant to antiretroviral agents. Epidemiology and Infectious Diseases. 2008;(3):46–51. (In Russ.).
  10. Tang MW, Shafer RW. HIV-1 antiretroviral resistance: scientific principles and clinical applications. Drugs. 2012;72(9):e1–25. doi: 10.2165/11633630-000000000-00000
  11. Bobkova MR. HIV drug resistance. Moscow: Chelovek; 2014. 288 p. (In Russ.).
  12. Zakharova NG, Dvorak SI, Guba ZV, et al. The causes of unfavorable outcomes among patients taking HAART. Part II. HIV Infection and Immunosuppressive Disorders. 2015;7(4):52–63. (In Russ.).
  13. Lebedeva NN, Zverev SYu, Kulagin VV, et al. HIV drug resistance early warning indicators and their assessment in some regions of Russia. HIV Infection and Immunosuppressive Disorders. 2018;10(4):67–75. (In Russ.). doi: 10.22328/2077-9828-2018-10-4-67-75
  14. Castagna A, Ferrara M, Galli L, et al; PRESTIGIO Study Group. Long-term efficacy of dolutegravir in treatment-experienced subjects failing therapy with HIV-1 integrase strand inhibitor-resistant virus. J Antimicrob Chemother. 2018;73(1):177–182. doi: 10.1093/jac/dkx371
  15. Rusconi S, Adorni F, Tau P, et al; ARCA (Antiviral Response Cohort Analysis). Dolutegravir (DTG)-containing regimens after receiving raltegravir (RAL) or elvitegravir (EVG): Durability and virological response in a large Italian HIV drug resistance network (ARCA). J Clin Virol. 2018;105:112–117. doi: 10.1016/j.jcv.2018.06.012
  16. Castagna A, Maggiolo F, Penco G, et al; VIKING-3 Study Group. Dolutegravir in antiretroviral-experienced patients with raltegravir- and/or elvitegravir-resistant HIV-1: 24-week results of the phase III VIKING-3 study. J Infect Dis. 2014;210(3):354–362. doi: 10.1093/infdis/jiu051
  17. Akil B, Blick G, Hagins DP, et al; VIKING-4 study team. Dolutegravir versus placebo in subjects harbouring HIV-1 with integrase inhibitor resistance associated substitutions: 48-week results from VIKING-4, a randomized study. Antivir Ther. 2015;20(3):343–348. doi: 10.3851/IMP2878
  18. Allavena C, Katlama C, Cotte L, et al; Dat’AIDS Study group. Long-term efficacy and safety of etravirine-containing regimens in a real-life cohort of treatment-experienced HIV-1- infected patients. Infect Dis (Lond). 2016;48(5):392–398. doi: 10.3109/23744235.2015.1133927
  19. New drug for multidrug-resistant HIV. Nat Biotechnol. 2018;36(4):291. doi: 10.1038/nbt0418-291b
  20. Beccari MV, Mogle BT, Sidman EF, et al. Ibalizumab, a Novel Monoclonal Antibody for the Management of Multidrug-Resistant HIV-1 Infection. Antimicrob Agents Chemother. 2019;63(6): e00110–00119. doi: 10.1128/AAC.00110-19
  21. Zhang H, Jin R, Yao C, et al. Combination of long-acting HIV fusion inhibitor albuvirtide and LPV/r showed potent efficacy in HIV-1 patients. AIDS Res Ther. 2016;13:8. doi: 10.1186/s12981-016-0091-1
  22. Kozal M, Aberg J, Pialoux G, et al.; BRIGHTE Trial Team. Fostemsavir in Adults with Multidrug-Resistant HIV-1 Infection. N Engl J Med. 2020;382(13):1232–1243. doi: 10.1056/NEJMoa1902493
  23. Kirichenko AA, Kireev DE, Lopatukhin AE, et al. Prevalence and structure of HIV-1 drug resistance among treatment naïve patients since the introduction of antiretroviral therapy in the Russian Federation. HIV Infection and Immunosuppressive Disorders. 2019;11(2):75–83. (In Russ.). doi: 10.22328/2077-9828-2019-11-2-75-83

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Tabl.6

Download (917KB)
Indexing metadata

Copyright (c) 2021 Nabiullina D.R., Mazus A.I., Litvinova N.G., Khamatova A.A., Nagibina M.V., Chebotareva T.A., Bessarab T.P., Ivannikov E.V., Smirnov N.A., Mashael V.S., Vlatshkaya Y.F.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies