{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T16:48:54Z","timestamp":1786121334408,"version":"build-2736575974"},"reference-count":36,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T00:00:00Z","timestamp":1785888000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100017638","name":"Ministry of Health of the Russian Federation","doi-asserted-by":"crossref","award":["056-02-2025-311"],"award-info":[{"award-number":["056-02-2025-311"]}],"id":[{"id":"10.13039\/501100017638","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100017638","name":"Ministry of Health of the Russian Federation","doi-asserted-by":"crossref","award":["056-02-2026-503"],"award-info":[{"award-number":["056-02-2026-503"]}],"id":[{"id":"10.13039\/501100017638","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>As critical geopolitical and migratory hubs in Eastern Europe, the Azov and Donbas regions represent an epidemiological melting pot for HIV-1 trafficking, exacerbating the global trend of rising dolutegravir (DTG) resistance through the cross-border dissemination of drug-resistant strains. This study presents a comprehensive molecular epidemiological analysis of HIV-1 in these regions in 2025 (N = 1666), focusing on drug resistance and cross-border transmission networks using phylogenetic and molecular network approaches. The study cohort was predominantly female (53.33%) and had heterosexual transmission (78.77%). Most patients (87.64%) received antiretroviral therapy (ART). Sub-subtype A6 predominated, with the radiation\u2019s origin traced to September 1994. Molecular network analysis identified the study area as a significant node, demonstrating viral exports towards the Russian Federation and Belarus, alongside multiple imports from Ukraine, Poland, and Russia. The overall resistance prevalence was 4.49% to integrase strand transfer inhibitors (INSTIs), 2.49% to protease inhibitors (PIs), 12.19% to nucleoside reverse transcriptase inhibitors (NRTIs), and 16.07% to non-nucleoside reverse transcriptase inhibitors (NNRTIs). Surveillance drug resistance mutations in treatment-naive individuals stood at 0.89% (INSTIs), 4.90% (PIs), 4.90% (NRTIs), and 8.82% (NNRTIs). Crucially, intermediate or high-level DTG resistance and key mutations (G118R, R263K, and Y143R) were detected in individuals without prior DTG exposure. This 4.49% integrase inhibitor resistance cannot be considered low; combined with intense cross-border viral dissemination, it may indicate the formation of a stable pool of resistant variants, potentially posing a risk of dolutegravir-based regimen failure and highlighting the need for enhanced regional molecular surveillance.<\/jats:p>","DOI":"10.3390\/v18080856","type":"journal-article","created":{"date-parts":[[2026,8,5]],"date-time":"2026-08-05T10:41:42Z","timestamp":1785926502000},"page":"856","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cross-Border Circulation and Molecular Surveillance of HIV-1 in the Azov and Donbas Regions: A Study of Genetic Diversity and Drug Resistance"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9180-9846","authenticated-orcid":false,"given":"Anastasiia","family":"Antonova","sequence":"first","affiliation":[{"name":"Federal State Budget Institution National Research Center for Epidemiology and Microbiology Named After the Honorary Academician N.F. Gamaleya, The Ministry of Health of the Russian Federation, 123098 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anatolii","family":"Vinokurov","sequence":"additional","affiliation":[{"name":"Federal State Budget Institution National Research Center for Epidemiology and Microbiology Named After the Honorary Academician N.F. Gamaleya, The Ministry of Health of the Russian Federation, 123098 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8382-275X","authenticated-orcid":false,"given":"Daria","family":"Kustova","sequence":"additional","affiliation":[{"name":"Federal State Budget Institution National Research Center for Epidemiology and Microbiology Named After the Honorary Academician N.F. Gamaleya, The Ministry of Health of the Russian Federation, 123098 Moscow, Russia"},{"name":"Department of Virology, Lomonosov Moscow State University, 119234 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1107-9351","authenticated-orcid":false,"given":"Andrei","family":"Pochtovyi","sequence":"additional","affiliation":[{"name":"Federal State Budget Institution National Research Center for Epidemiology and Microbiology Named After the Honorary Academician N.F. Gamaleya, The Ministry of Health of the Russian Federation, 123098 Moscow, Russia"},{"name":"Department of Medical Genetics and Postgenomic Technologies, Sechenov First Moscow State Medical University, 119991 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1152-4120","authenticated-orcid":false,"given":"Daria","family":"Ogarkova","sequence":"additional","affiliation":[{"name":"Federal State Budget Institution National Research Center for Epidemiology and Microbiology Named After the Honorary Academician N.F. Gamaleya, The Ministry of Health of the Russian Federation, 123098 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7514-5944","authenticated-orcid":false,"given":"Ruslan","family":"Adgamov","sequence":"additional","affiliation":[{"name":"Federal State Budget Institution National Research Center for Epidemiology and Microbiology Named After the Honorary Academician N.F. Gamaleya, The Ministry of Health of the Russian Federation, 123098 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5299-3081","authenticated-orcid":false,"given":"Anna","family":"Kuznetsova","sequence":"additional","affiliation":[{"name":"Federal State Budget Institution National Research Center for Epidemiology and Microbiology Named After the Honorary Academician N.F. Gamaleya, The Ministry of Health of the Russian Federation, 123098 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Tsyganova","sequence":"additional","affiliation":[{"name":"Moscow City Center for AIDS Prevention and Control, 105275 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Inna","family":"Kulikova","sequence":"additional","affiliation":[{"name":"Department of Emergency Medical Assistance Organisation and Health Risk Management of the Ministry of Health of the Russian Federation, 127994 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei","family":"Plutnitskii","sequence":"additional","affiliation":[{"name":"Federal Medical Biophysical Center Named After A.I. Burnazyan, 123098 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vladimir","family":"Gushchin","sequence":"additional","affiliation":[{"name":"Federal State Budget Institution National Research Center for Epidemiology and Microbiology Named After the Honorary Academician N.F. Gamaleya, The Ministry of Health of the Russian Federation, 123098 Moscow, Russia"},{"name":"Department of Virology, Lomonosov Moscow State University, 119234 Moscow, Russia"},{"name":"Department of Medical Genetics and Postgenomic Technologies, Sechenov First Moscow State Medical University, 119991 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksandr","family":"Gintsburg","sequence":"additional","affiliation":[{"name":"Federal State Budget Institution National Research Center for Epidemiology and Microbiology Named After the Honorary Academician N.F. Gamaleya, The Ministry of Health of the Russian Federation, 123098 Moscow, Russia"},{"name":"Department of Infectiology and Virology, Sechenov First Moscow State Medical University, 119991 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denis","family":"Logunov","sequence":"additional","affiliation":[{"name":"Federal State Budget Institution National Research Center for Epidemiology and Microbiology Named After the Honorary Academician N.F. Gamaleya, The Ministry of Health of the Russian Federation, 123098 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aleksei","family":"Mazus","sequence":"additional","affiliation":[{"name":"Moscow City Center for AIDS Prevention and Control, 105275 Moscow, Russia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,5]]},"reference":[{"key":"ref_1","unstructured":"UNAIDS (2025, March 17). Fast Sheet 2025. Global HIV Statistics. 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