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2025 ; 25
(1
): 1393
Nephropedia Template TP
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Pre-treatment and acquired HIV drug resistance in Hunan: a cross-sectional
analysis of a growing challenge
#MMPMID41131459
Long S
; Yao R
; Tang Y
; Yu C
; Tang W
; Cao J
; Huang Y
; Lu X
; Li S
; Liu R
; Dai L
; Huang Y
; Zheng F
BMC Infect Dis
2025[Oct]; 25
(1
): 1393
PMID41131459
show ga
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.