ArticleFrontiers in public health2026
Characterization of drug resistance mutations in people living with HIV with low-level viremia on antiretroviral therapy in Chongqing, China.
Article in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To investigate the prevalence and patterns of drug resistance mutations (DRMs) and associated risk factors among ART-experienced people living with HIV (PLWH) exhibiting low-level viremia (LLV; 50-999 copies/mL) in Chongqing, China, and to evaluate the utility of a combined plasma RNA and proviral DNA genotyping strategy. Methods: In this cross-sectional study (September 2023-February 2024), we screened 4,941 ART-treated individuals, identifying 210 with LLV. Genotypic resistance testing targeting the protease, reverse transcriptase, and integrase regions was successfully performed for 133 participants (63.33%) using a dual-source (plasma RNA and/or proviral DNA) approach. HIV-1 subtyping and DRM analysis were conducted using the Stanford HIVdb algorithm and phylogenetic methods. Results: The overall prevalence of LLV was 4.25%. CRF07_BC was the predominant HIV-1 subtype (76.69%). DRMs were detected in 26.32% (35/133) of the cohort. Resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) was most common (19.55%), primarily driven by V179D/E and G190A/S/E mutations. Resistance to nucleoside reverse transcriptase inhibitors (NRTIs) and integrase strand transfer inhibitors (INSTIs) was observed in 12.03 and 3.76% of participants, respectively, with M184V/I being the predominant NRTI mutation. No significant differences in DRM prevalence were observed across viral subtypes. In multivariate analysis, baseline CD4 Conclusion: This study reveals a considerable prevalence of drug mutations (DRMs), predominantly against NNRTIs, among ART-experienced PLWH with LLV in Chongqing. The combined RNA/DNA genotyping strategy significantly enhanced DRM detection sensitivity in this low viral load cohort, underscoring its value for resistance surveillance and guiding clinical management in resource-limited settings.
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