A portable laboratory operating from a van has identified a new drug-resistant HIV strain in Ukraine following the expansion of the war in 2022. The finding offers direct genomic evidence that conflict and displacement have altered patterns of transmission. The project, led by virologist of the University of California, Irvine, demonstrates how mobile sequencing can function where stationary laboratories cannot.
Table of contents
- Ganna Kovalenko and University of California, Irvine mobile lab
- Casper Rokx and Erasmus MC stationary clinics in Lviv
- HIV mutation and antiretroviral drug resistance in Ukraine
Ganna Kovalenko and University of California, Irvine mobile lab
Portable sequencing during active conflict
HIV has spread in Ukraine since the 1990s. Transmission has been linked mainly to intravenous drug use and also sexual contact. According to Kovalenko, the 2014 Russian invasion of Crimea and the expanded assault in 2022 reduced access to testing, treatment and prevention programs, including needle exchange initiatives.
Routine genome sequencing is not standard in many clinics. Laboratories are often located far from outbreak areas. As a result, mutations associated with drug resistance may go undetected.
The ARTIC network, previously active during the 2014 Ebola outbreaks in West Africa, aims to bring sequencing tools to remote or inaccessible regions. Kovalenko, a member of the network, decided to test whether portable sequencing could track HIV spread in Ukraine. She and her colleagues built a lab inside a van.
In August 2024, the team drove to Lviv. The city in western Ukraine became a hub for displaced residents. They worked during the day, when missile attacks were less frequent. Local healthcare workers described interrupting patient care during daytime strikes and leaving equipment behind to evacuate quickly.
Casper Rokx and Erasmus MC stationary clinics in Lviv
Limits of fixed facilities
Before the mobile initiative, HIV monitoring relied on stationary clinics, an HIV specialist at, established fixed facilities in Lviv from 2023 to 2025.
He reported that these centers did not effectively reach hard-to-access groups. Vans, by contrast, can travel directly to affected communities.
During a 3-day pilot in August 2024, Kovalenko’s team collected blood samples from 20 HIV-positive individuals. She expected only to test the feasibility of the mobile setup. Instead, the group identified a distinct HIV strain among displaced residents in Lviv.
The researchers reported in the journal AIDS that this strain emerged after the war expanded in 2022. By comparing its genome with other HIV genomes sequenced in 2020 and analyzing mutation rates, they estimated its appearance followed the broader invasion.
HIV mutation and antiretroviral drug resistance in Ukraine
Genomic evidence of resistance
The team detected a mutation in a viral gene that confers resistance to a backup antiretroviral drug. This discovery raised concern about future treatment options.
Rokx noted that resistance to first-line HIV therapies is increasing in other regions, including South Africa. He warned that additional sequencing among displaced populations could reveal further mutations.
Key findings from the Lviv pilot include:
- 20 HIV-positive participants sampled
- 1 newly identified strain linked to post-2022 displacement
- 1 mutation associated with resistance to a backup antiretroviral drug
- Genomic comparison with 2020 reference sequences
Kovalenko plans to expand the van’s use. Potential applications include sequencing bacteria from infected wounds among soldiers. Antimicrobial resistance is a frontline concern. Tuberculosis is also rising in Ukraine, and its bacterial cause often shows multidrug resistance.
The mobile laboratory provides field-based genomic analysis in areas where conventional facilities are inaccessible. Rokx stated that the project brought advanced sequencing techniques directly to a population in need, and readers can find more here.
War has provided a smokescreen for HIV to spread and mutate, but this van could help researchers pierce through that fog. “I think what they nicely did was bring deep sequencing and advanced laboratory technique to a population in need,” Rokx says, with additional public health coverage available under drug resistance.
FAQ
What did the mobile laboratory identify in Ukraine?
It identified a drug-resistant HIV strain in Ukraine after the expansion of the war in 2022.
Who led the project using the van-based lab?
The project was led by virologist Ganna (Anna) Kovalenko of the University of California, Irvine.
Where did the team run the August 2024 test drive?
They drove to Lviv, a western Ukrainian hub for displaced people.
How many HIV-positive participants were sampled during the pilot?
The team sampled blood from 20 HIV-positive people.
What evidence linked the newly found strain to the post-2022 period?
By comparing the strain’s genome to HIV genomes sequenced in 2020 and using mutation rates, the researchers estimated it emerged after the invasion expanded in 2022.
What resistance-related mutation did the researchers detect?
They found a mutation in a virus gene that made it resistant to a backup antiretroviral drug.
What did Casper Rokx do in Lviv from 2023 to 2025?
Casper Rokx set up stationary clinics in Lviv to provide HIV care from 2023 to 2025.
Why did the van approach matter compared with stationary clinics?
Rokx said stationary clinics did not reach hard-to-reach populations as effectively, while vans can drive to where people are.
What other sequencing applications did Kovalenko mention?
She said bacterial genome sequencing could help guide antibiotic choices for infected wounds among soldiers, and noted tuberculosis as a growing burden in Ukraine with frequent multidrug resistance.
Source: Science News