Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jul 11:16:1617795.
doi: 10.3389/fmicb.2025.1617795. eCollection 2025.

HIV drug resistance and its associated factors among patients during interruption of antiretroviral therapy in China

Zhongbao Zuo #  1 , Wei Huang #  2 , Lei Liu  3 , Miaomiao Li  3 , Hongli Chen  3 , Yi Feng  3 , Lingjie Liao  3 , Yiming Shao  3 , Yuhua Ruan  3 , Jing Wu  1 , Hui Xing  3
Affiliations

HIV drug resistance and its associated factors among patients during interruption of antiretroviral therapy in China

Zhongbao Zuo et al. Front Microbiol. .

Abstract

Background: The prevalence of human immunodeficiency virus (HIV) drug resistance among people living with HIV (PLWH) who experience treatment interruptions is a significant concern. This study aimed to investigate the prevalence and characteristics of HIV drug resistance for PLWH who experienced treatment interruptions in China.

Methods: This study included 595 PLWH from four studies conducted in China between 2003 and 2021. Data were collected through face-to-face questionnaires, and HIV drug resistance was genotyped using an in-house assay. Multivariate logistic regression analysis was performed to identify factors associated with drug resistance.

Results: The prevalence of drug resistance was 19.6% (83/424). The most frequent drug resistance mutation was K103N (12.9%). The HIV drug resistance rate and the frequency of patients harboring ≥2 drug resistance mutations decreased significantly in the longer interruption time group. Chi-square trend tests showed that HIV drug resistance, NNRTI drug resistance, K1O3N mutation, and viral load significantly decreased in the longer interruption time group. Multivariate logistic regression analysis revealed that viral load ≥15,000 copies/mL (AOR: 0.58, 95% CI: 0.34-0.98, p = 0.04), interruption time ≥24 months (AOR: 0.29, 95% CI: 0.13-0.63, p = 0.002), and ART duration of 12-24 months before interruption (AOR: 0.36, 95% CI: 0.17-0.76, p = 0.01) were significantly associated with HIV drug resistance.

Conclusion: The study found that the prevalence of HIV drug resistance among PLWH who experienced treatment interruptions in China was 19.6%. These findings highlight the importance of conducting drug resistance tests for patients with interruptions before reinitiating ART, especially when the viral load is> 1,000 copies/mL.

Keywords: HIV; drug resistance; interruption of antiretroviral therapy; mutation; viral load.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of HIV patients with treatment interruption and patient enrollment, 596 patients were included in the final analysis. IT, interruption time.
Figure 2
Figure 2
HIV drug resistance mutations among different ART interruption times.
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Acquired Immunodeficiency Syndrome Professional Group, Society of Infectious Diseases, Chinese Medical Association, Chinese Center for Disease Control and Prevention (2024). Chinese guidelines for the diagnosis and treatment of human immunodeficiency virus infection/acquired immunodeficiency syndrome (2024 edition). Chin. Med. J. 137, 2654–2680. doi: 10.1097/CM9.0000000000003383 - DOI - PMC - PubMed
    1. Cao P., Su B., Wu J., Wang Z., Yan J., Song C., et al. (2018). Treatment outcomes and HIV drug resistance of patients switching to second-line regimens after long-term first-line antiretroviral therapy: an observational cohort study. Medicine (Baltimore) 97:e11463. doi: 10.1097/MD.0000000000011463, PMID: - DOI - PMC - PubMed
    1. Chen H., Hao J., Hu J., Song C., Zhou Y., Li M., et al. (2023). Pretreatment HIV drug resistance and the molecular transmission network among HIV-positive individuals in China in 2022: multicenter observational study. JMIR Public Health Surveill. 9:e50894. doi: 10.2196/50894, PMID: - DOI - PMC - PubMed
    1. DHHS . Guidelines for the use of antiretroviral agents in adults and adolescents with HIV (2024). Available online at: https://clinicalinfo.hiv.gov/en/guidelines/hiv-clinical-guidelines-adult... (accessed March 15, 2025).
    1. EACS . EACS Guidelines 2024 (2024). Available online at: https://eacs.sanfordguide.com/ (accessed March 15, 2025).

LinkOut - more resources