HIV-1 genotypic patterns in antiretroviral-naïve and treated patients in the integrase inhibitor era in Morocco

@article{ahmina2026hiv1,
  title = {{HIV-1 genotypic patterns in antiretroviral-naïve and treated patients in the integrase inhibitor era in Morocco}},
  author = {Maryam Ahmina and Hicham El Annaz and Ahmed Reggad and Nada Lamrak and Mohamed Rida Tagajdid and Rachid Abi and Mohamed Elqatni and Abdelilah Laraqui and Safae Elkochri and Elarbi Bouaiti and Fadoua El Amraoui and Yassine Elbnaissi and Imane Hamdouni and Bouchra El Mchichi and Nadia Touil and Khalid Ennibi and Idriss Amine Lahlou},
  journal = {BMC Infectious Diseases},
  year = {2026},
  month = jul,
  doi = {10.1186/s12879-026-14005-y},
  url = {https://doi.org/10.1186/s12879-026-14005-y},
  note = {CC BY},
}

TY  - JOUR
TI  - HIV-1 genotypic patterns in antiretroviral-naïve and treated patients in the integrase inhibitor era in Morocco
AU  - Maryam Ahmina
AU  - Hicham El Annaz
AU  - Ahmed Reggad
AU  - Nada Lamrak
AU  - Mohamed Rida Tagajdid
AU  - Rachid Abi
AU  - Mohamed Elqatni
AU  - Abdelilah Laraqui
AU  - Safae Elkochri
AU  - Elarbi Bouaiti
AU  - Fadoua El Amraoui
AU  - Yassine Elbnaissi
AU  - Imane Hamdouni
AU  - Bouchra El Mchichi
AU  - Nadia Touil
AU  - Khalid Ennibi
AU  - Idriss Amine Lahlou
PY  - 2026
DA  - 2026/07/01
JO  - BMC Infectious Diseases
DO  - 10.1186/s12879-026-14005-y
UR  - https://doi.org/10.1186/s12879-026-14005-y
AB  - Background HIV-1 drug resistance remains a critical challenge for long-term treatment effectiveness, particularly in settings characterized by diverse viral subtypes and evolving treatment histories. We investigated the prevalence, patterns, and molecular distribution of transmitted and acquired HIV-1 drug-resistance mutations in a Moroccan cohort. Methods A cross-sectional molecular study was performed on HIV-1–infected individuals monitored at the CVMIT in Rabat from 2024 to 2025. Demographic, clinical, and virological data were collected retrospectively from medical records. The HIV-1 pol gene was amplified and sequenced. Drug-resistance mutations were interpreted using the Stanford HIVdb v9.8 algorithm, and resistance profiles were examined by drug class, resistance level, treatment history, and viral subtype. Results Major surveillance drug-resistance mutations were detected in 3 of 38 ART-naïve individuals (7.9%), indicating a low but measurable burden of transmitted resistance. These mutations were limited to protease inhibitor- and non-nucleoside reverse transcriptase inhibitor-associated substitutions, with no major transmitted resistance detected in nucleoside reverse transcriptase inhibitors or integrase inhibitors. Among ART-experienced patients, 11 of 26 individuals (42.3%) harbored at least one major resistance mutation. Acquired resistance was dominated by NNRTI mutations, led by K103N/S (19.2%), Y188L/H, and V106I/L (15.4%) each, followed by NRTI mutations including M184V/I (19.2%), D67N, and K70R/E (15.4%) each. Integrase inhibitor resistance was detected in three treated individuals (11.5%), involving R263K/T, Q148K, and N155H. No major protease inhibitor resistance was identified among treated patients. CRF02_AG accounted for the majority of major resistance mutations across drug classes. Conclusions This study provides a detailed overview of HIV-1 DRMs in Morocco, revealing persistent NNRTI and NRTI resistance within a CRF02_AG-dominant epidemic and the emergence of INSTI mutations under DTG pressure. These findings emphasize the urgency of nationwide genotypic surveillance to guide ART management and preserve treatment efficacy.
SN  - 1471-2334
ER  -