Altai Krai is a region with an unfavorable situation of HIV-1 and HCV infection, as well as HIV-1 and HCV coinfection. Due to this, it is necessary to study the HCV genetic variants and their drug resistance (DR) to direct-acting antivirals (DAAs) in patients with HIV-1 and HCV coinfection.The analysis of HCV genome fragments encoding NS5A and NS5B proteins in samples obtained from treatment-naïve residents of Altai Krai with newly diagnosed HIV and HCV co-infection to determine the genetic variant of HCV and genetic features of the virus associated with its sensitivity to NS5A and NS5B inhibitors.Blood plasma samples (n = 286) collected in 2022-2023 from HIV-infected individuals were analyzed for HCV markers. The HCV RNA concentration was measured, nucleotide sequences of NS5A and NS5B and Core (for HCV 2k/1b samples) fragments were obtained, the subtype was determined, and DR and polymorphic positions were analyzed.Antibodies to HCV were detected in 94/286 (32.86%) samples, sequences were obtained from 52 samples. Subtypes 3a, 1b, recombinant form 2k/1b and subtype 1a were found in 28 (53.85%), 17 (32.69%), 5 (9.62%) and one (1.92%) samples, respectively. One sample harbored HCV 1b + 3a mix-infection. Reduced sensitivity (5.66%) and complete resistance (9.43%) to the NS5A inhibitor daclatasvir were most often detected. Certain gene polymorphisms were identified in the sequences.Our results may indirectly indicate the increasing proportion of the HCV subtype 3a in the hepatitis C epidemic in the Altai Territory. Our data on DR and polymorphisms should be taken into account in antiviral therapy of patients.