HIV-1 drug resistance and associated risk factors in antiretroviral therapy failure: a 2022–2024 surveillance in Huzhou, China
- 1Department of Clinical Microbiology, Huzhou Center for Disease Control and Prevention (Huzhou Municipal Health Inspection and Supervision Agency), Huzhou
- 2Department of Clinical Laboratory, The First People’s Hospital of Huzhou, Huzhou
- 3Department of HIV/TB Control and Prevention, Huzhou Center for Disease Control and Prevention (Huzhou Municipal Health Inspection and Supervision Agency), Huzhou
Abstract
Introduction: Characterizing acquired drug resistance (ADR) profiles among individuals experiencing antiretroviral therapy (ART) failure is critical for optimizing clinical management.
Methods: This study aimed to delineate the HIV-1 drug resistance landscape, specific resistance-associated mutations, and epidemiological determinants in Huzhou, China, from 2022 to 2024. Blood samples and epidemiological data were collected from 184 HIV-1-infected patients experiencing ART failure. Viral pol region sequences were amplified, and drug resistance mutations (DRMs) were interpreted using the Stanford University HIV Drug Resistance Database.
Results: The overall prevalence of ADR was 44.0% (81/184). Resistance to protease inhibitors (PIs) remained notably low at 1.6%,whereas the prevalence of DRMs associated with nucleoside (NRTIs) and non nucleoside reverse transcriptase inhibitors (NNRTIs) reached 27.7% and 41.8%, respectively. The most frequently detected NRTI-associated DRMs included M184V/I and K65R, while dominant NNRTI-associated mutations comprised V179D/E/F, K103N, V106I/L/M, G190A/Q/S/T, and Y181C/L. Furthermore, multivariable logistic regression identified patient age, plasma viral load, and specific HIV-1 subtypes as independent risk factors for DRM development.
Discussion: Ultimately, this study elucidates the evolving mutational landscape among ART-experienced individuals, providing critical evidence-based insights for optimizing personalized antiretroviral regimens and mitigating the onward transmission of drug-resistant HIV-1 variants within the region.
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BibTeX
@article{lu2026hiv1,
title = {{HIV-1 drug resistance and associated risk factors in antiretroviral therapy failure: a 2022–2024 surveillance in Huzhou, China}},
author = {Zhonghao Lu and Yijie Wu and Yunfeng Zha and Fenfen Dong and Zhongrong Yang and Lei Ji and Xiaojuan Zhu},
journal = {Frontiers in Microbiology},
year = {2026},
month = oct,
doi = {10.3389/fmicb.2026.1933938},
url = {https://www.frontiersin.org/articles/10.3389/fmicb.2026.1933938/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - HIV-1 drug resistance and associated risk factors in antiretroviral therapy failure: a 2022–2024 surveillance in Huzhou, China
AU - Zhonghao Lu
AU - Yijie Wu
AU - Yunfeng Zha
AU - Fenfen Dong
AU - Zhongrong Yang
AU - Lei Ji
AU - Xiaojuan Zhu
PY - 2026
DA - 2026/10/29
JO - Frontiers in Microbiology
DO - 10.3389/fmicb.2026.1933938
UR - https://www.frontiersin.org/articles/10.3389/fmicb.2026.1933938/full
AB - Introduction: Characterizing acquired drug resistance (ADR) profiles among individuals experiencing antiretroviral therapy (ART) failure is critical for optimizing clinical management. Methods: This study aimed to delineate the HIV-1 drug resistance landscape, specific resistance-associated mutations, and epidemiological determinants in Huzhou, China, from 2022 to 2024. Blood samples and epidemiological data were collected from 184 HIV-1-infected patients experiencing ART failure. Viral pol region sequences were amplified, and drug resistance mutations (DRMs) were interpreted using the Stanford University HIV Drug Resistance Database. Results: The overall prevalence of ADR was 44.0% (81/184). Resistance to protease inhibitors (PIs) remained notably low at 1.6%,whereas the prevalence of DRMs associated with nucleoside (NRTIs) and non nucleoside reverse transcriptase inhibitors (NNRTIs) reached 27.7% and 41.8%, respectively. The most frequently detected NRTI-associated DRMs included M184V/I and K65R, while dominant NNRTI-associated mutations comprised V179D/E/F, K103N, V106I/L/M, G190A/Q/S/T, and Y181C/L. Furthermore, multivariable logistic regression identified patient age, plasma viral load, and specific HIV-1 subtypes as independent risk factors for DRM development. Discussion: Ultimately, this study elucidates the evolving mutational landscape among ART-experienced individuals, providing critical evidence-based insights for optimizing personalized antiretroviral regimens and mitigating the onward transmission of drug-resistant HIV-1 variants within the region.
SN - 1664-302X
ER -