Work

Pre-treatment and acquired HIV drug resistance in Hunan: a cross-sectional analysis of a growing challenge

Year: 2025

Type: article

Abstract: BACKGROUND: HIV Drug Resistance (HIVDR) is a key consideration when determining ART regimens. In recent years, Pre-treatment Drug Resistance (PDR) and Acquired Drug Resistance (ADR) have been changing rapidly. We studied the latest PDR and ADR cases in Hunan Province, China. METHOD: The study included People Living With HIV (PLWH) from a hospital in Hunan Province (May 2021–August 2023). Baseline characterisation data were collected from participants. HIV-1 pol sequences were amplified, sequenced, and analyzed for DR mutations, which were analyzed using the Stanford University HIVDR database. Descriptive analysis was used for statistical descriptions. RESULTS: 1,314 PLWH (1,277 successfully tested) were included in the study. Among 917 treatment-naïve PLWH, the most prevalent subtypes were CRF07_BC (41.8%) and CRF01_AE (38.4%), PDR was 14.7% (135/917), with NNRTIs DR rate at 11.6%(mainly NVP 11.6%, EFV 11.1%, RPV 6.7%), NRTIs at 3.6% (mainly ABC 3.4%, 3TC/FTC 3.3%, DDI 1.6%), while INSTIs and PIs remained ≤ 1.1%, NNRTIs mutations were most prevalent in V170D/E/L(5.1%) and K238N(3.2%), NRTIs were t in M184I/V(3.3%) and K70E/N/Q/R(0.5%), INSTIs/ PIs were ≤ 0.7%. Among 360 treatment-failure PLWH, the most prevalent subtypes were CRF01_AE (43.1%) and CRF07_BC (26.4%), ADR reached 67.2% (242/360), and NNRTIs DR rate was 54.7%(mainly NVP 54.2%, EFV 52.5%, RPV 38.3%) and NRTIs was 38.1%(mainly 3TC 35.3%, ABC 35.0%, FTC 34.4%,). INSTIs and PIs were ≤ 4.2%, NNRTIs mutations were most prevalent in V170D/E/Q/I/T(20.0%) and K103N/T/R/S(16.9%), NRTIs were in M184I/V(30.8%) and K65R(12.5%), INSTIs/PIs were ≤ 3.3%. CONCLUSION: Both HIV-1 PDR and ADR were challenged in Hunan Province, China. DR testing should be conducted before selecting an ART regimen to guide the initial regimen or develop a more precise regimen. For PLWH who fail to complete DR testing, choosing a regimen containing PIs or INSTIs with a high resistance barrier is more advisable.

Source: BMC Infectious Diseases

DOI: 10.1186/s12879-025-11656-1