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September 18, 2026JMIR Public Health and SurveillanceOpen Access

Genetic Subtypes, Pretreatment Drug Resistance, and Associated Factors Among Individuals Newly Diagnosed With HIV-1 in Zhejiang Province From 2022 to 2024: Cross-Sectional Study

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Authors

WCWei ChengQFQin FanJZJiafeng Zhang

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Overview

Cross-sectional study uncovers rising pretreatment drug resistance in newly diagnosed HIV-1 individuals, highlighting the need for enhanced resistance surveillance and pre-prophylaxis testing.

Key Points

  • Characterize HIV-1 genetic subtype distribution, determine the prevalence of pretreatment drug resistance, and identify associated demographic, virological, and prophylaxis-related factors.
  • Cross-sectional study analyzing 8,798 adults newly diagnosed with HIV-1 in Zhejiang Province, China, between 2022 and 2024.
  • HIV-1 subtypes and resistance mutations were characterized through partial Pol gene sequencing and interpreted using the Stanford University HIV Drug Resistance Database.
  • Multivariable logistic regression models were applied to identify factors independently associated with pretreatment drug resistance.
  • Predominant subtypes were CRF07_BC (44.5%, n=3,913), CRF01_AE (28.7%, n=2,524), and CRF08_BC (10.8%, n=954), showing significant demographic and temporal heterogeneity (P < .001).
  • Pretreatment drug resistance prevalence was 5.7% (n=504), primarily driven by resistance to nonnucleoside reverse-transcriptase inhibitors (4.0%, n=352), with K103N, M184V, and M46L being the most frequent mutations.
  • Higher baseline CD4 counts, diagnosis in 2023 or 2024, and CRF01_AE subtype infection were independently associated with higher resistance odds, while exposure prophylaxis was significantly associated with resistance to emtricitabine (P < .001) and lamivudine (P < .001).

Cite This Study

Cheng et al. (2026) studied this question.

synapsesocial.com/papers/6aad0bfcde0393d728b8a8abhttps://doi.org/10.2196/96139
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Pretreatment HIV-1 drug resistance and molecular subtype characteristics among newly diagnosed individuals in Guangxi, China2026
  2. 2Characterization of Pretreatment Drug Resistance among people living with HIV from 2018 to 2022 in Guangzhou, China2024
  3. 3Molecular epidemiology and pretreatment drug resistance of HIV-1 among newly diagnosed individuals in Nanning City, Guangxi, China.2025 · 3 citations
  4. 4Exploring disparities in HIV-1 pretreatment and acquired drug resistance in China from 2003 to 20222024
  5. 5Molecular Transmission Network and Pretreatment Drug Resistance of Newly Diagnosed HIV-1 Infections in Taizhou, a Coastal City in Eastern China, from 2021–20232025 · 3 citations