The ongoing conflict in Ukraine has severely disrupted healthcare, creating conditions for unchecked disease transmission, including HIV. While the extent of the problem remained unclear, a team led by virologist Ganna Kovalenko of the University of California, Irvine, is now using a mobile laboratory to investigate HIV’s spread in war-torn regions.
The Crisis in Ukraine
Ukraine has grappled with HIV since the 1990s, primarily through intravenous drug use and sexual transmission. However, the Russian invasion, beginning with the annexation of Crimea in 2014 and escalating in 2022, has dramatically worsened the situation. Reduced access to testing, treatment, and harm reduction programs (like needle exchanges) has accelerated contagion.
The problem is exacerbated by the lack of viral sequencing. Routine genomic analysis is crucial for detecting drug resistance mutations, but sequencing often requires centralized labs inaccessible in conflict zones.
The Mobile Lab Solution
To overcome this limitation, Kovalenko’s team built a fully equipped laboratory inside a van. Inspired by similar initiatives like the ARTIC network – previously deployed during the 2014 Ebola outbreak in West Africa – this mobile unit brings advanced diagnostic tools directly to affected populations.
During a test run in August 2024, the team operated in Lviv, a western Ukrainian hub for internally displaced persons. Kovalenko described the realities of working in a war zone: “They describe situations where missile attacks start during the day while they are providing care, and they had to react immediately, leaving everything behind and driving away as fast as possible.”
Key Findings: A New Strain Emerges
Traditional stationary clinics, such as those run by Dr. Casper Rokx between 2023-2025, struggled to reach the most vulnerable populations. “We didn’t reach the hard-to-reach populations, at least not as effectively as we wanted that to be,” Rokx admits. The mobile lab offers a significant advantage: it can “just drive to where people are.”
In their initial sample of 20 HIV-positive individuals, Kovalenko’s team unexpectedly discovered a novel HIV strain that emerged among displaced Ukrainians after the 2022 escalation. Published in the journal AIDS, the analysis suggests the strain arose after the full-scale invasion, confirming a direct link between war and altered HIV transmission patterns.
More concerning, the new strain carried a mutation rendering it resistant to a backup antiretroviral drug. This discovery raises the alarm that further mutations impacting first-line treatments may be imminent. Drug resistance is already a growing threat in regions like South Africa, as Rokx notes.
Future Implications: Beyond HIV
Kovalenko’s team envisions expanding the mobile lab’s capabilities. Antimicrobial resistance is rampant in war zones, where soldiers often suffer infected wounds. Sequencing bacterial genomes could guide clinicians toward appropriate antibiotic prescriptions. Tuberculosis, another growing concern in Ukraine, is also frequently drug-resistant.
The war has created a breeding ground for viral evolution, but this mobile approach could help researchers track and understand these changes in real-time. “I think what they nicely did was bring deep sequencing and advanced laboratory technique to a population in need,” Rokx concludes.
In summary, the combination of conflict and limited healthcare access is driving dangerous mutations in HIV and other infectious diseases. The mobile lab represents a vital intervention, bringing crucial research capabilities directly to those most affected by the crisis.
