ArticleBMC infectious diseases2026
HIV-1 genotypic patterns in antiretroviral-naïve and treated patients in the integrase inhibitor era in Morocco.
Article in BMC infectious diseases, 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
backgroundHIV-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.
methodsA 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.
resultsMajor 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.
conclusionsThis 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.
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