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Abstract Although most people living with HIV (PLWH) receiving antiretroviral therapy (ART) achieve continuous viral suppression, some show detectable HIV RNA as low-level viremia (LLV) (50–999 copies/mL). Drug resistance mutations (DRMs) in PLWH with LLV is of particular concern as which may lead to treatment failure. In this study, we investigated the prevalence of LLV and LLV-associated DRMs in PLWH in Zhengzhou City, China. Of 3616 ART-experienced PLWH in a long-term follow-up cohort from Jan 2022 to Aug 2023, 120 were identified as having LLV. Of these PLWH with LLV, we obtained partial pol and integrase sequences from 104 (70 from HIV-1 RNA and 34 from proviral DNA) individuals. DRMs were identified in 44 individuals. Subtyping analysis indicated that the top three subtypes were B (48. 08%, 50/104), CRF07BC (31. 73%, 33/104), and CRF01AE (15. 38%, 16/104). The proportions of nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and integrase strand transfer inhibitors (INSTIs) associated DRMs were 23. 83% (24/104), 35. 58% (37/104), 5. 77% (6/104), and 3. 85% (4/104), respectively, which contributed to an overall prevalence of 42. 31% (44/104). When analyzed by individual DRMs, the most common mutation (s) were V184 (18. 27%, 19/104), followed by V179 (11. 54%, 12/104), K103 (9. 62%, 10/104), Y181 (9. 62%, 10/104), M41 (7. 69%, 8/104), and K65R (7. 69%, 8/104). The prevalence of DRMs in ART-experienced PLWH with LLV is high in Zhengzhou City and continuous surveillance can facilitate early intervention and provision of effective treatment.
Liu et al. (Thu,) studied this question.