{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,23]],"date-time":"2025-09-23T12:45:09Z","timestamp":1758631509361,"version":"3.37.3"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T00:00:00Z","timestamp":1695859200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100003711","name":"Ministry of Science and Technology's","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003711","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Key R&D Program of China","award":["2022YFC2305201","2022YFC2305202"],"award-info":[{"award-number":["2022YFC2305201","2022YFC2305202"]}]},{"name":"State Key Laboratory for Infectious Disease Prevention and Control of China","award":["2022SKLID201"],"award-info":[{"award-number":["2022SKLID201"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,11,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To assess the impact of pretreatment low-abundance HIV drug-resistant variants (LA-DRVs) on virological outcomes among ART-naive HIV-1-infected Chinese people who initiated ART.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A nested case\u2013control study was conducted among HIV-1-infected individuals who had pretreatment drug resistance (PDR) genotypic results. Cases were defined as individuals with virological failure (HIV-1 RNA viral load \u22651000 copies\/mL) after 1 year of ART, and controls were individuals from the same cohort whose viral load was less than 1000 copies\/mL. Next-generation sequencing was used to identify low-abundance PDR mutations at detection thresholds of 10%, 2% and 1%. The mutant load was calculated by multiplying the abundance of HIV-1 drug-resistant variants by the pretreatment viral load. The impact of pretreatment low-abundance mutations on virological failure was estimated in logistic regression models.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Participants (43 cases and 100 controls) were included in this study for the analysis. The proportion of participants with PDR was higher in cases than in controls at different detection thresholds (44.2% versus 22.0%, P\u200a=\u200a0.007 at 10% threshold; 58.1% versus 31.0%, P\u200a=\u200a0.002 at 2% threshold; 90.7% versus 69.0%, P\u200a=\u200a0.006 at 1% threshold). Compared with participants without PDR, participants with \u226510% detectable PDR mutations were associated with an increased risk of virological failure (adjusted OR 8.0, 95% CI 2.4\u201326.3, P\u200a=\u200a0.001). Besides this, individuals with pretreatment LA-DRVs (2%\u20139% abundance range) had 5-fold higher odds of virological failure (adjusted OR 5.0, 95% CI 1.3\u201319.6, P\u200a=\u200a0.021). Furthermore, LA-DRVs at 2%\u20139% abundance resistant to NRTIs and mutants with abundance of \u226510% resistant to NNRTIs had a 4-fold and 8-fold risk of experiencing virological failure, respectively. It was also found that a mutant load of more than 1000 copies\/mL was predictive of virological failure (adjusted OR 7.2, 95% CI 2.5\u201321.1, P\u200a=\u200a0.0003).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Low-abundance PDR mutations ranging from 2% to 9% of abundance can increase the risk of virological failure. Further studies are warranted to define a clinically relevant threshold of LA-DRVs and the role of NRTI LA-DRVs.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/jac\/dkad297","type":"journal-article","created":{"date-parts":[[2023,9,28]],"date-time":"2023-09-28T19:09:41Z","timestamp":1695928181000},"page":"2743-2751","source":"Crossref","is-referenced-by-count":4,"title":["Impact of pretreatment low-abundance HIV-1 drug resistance on virological failure after 1 year of antiretroviral therapy in China"],"prefix":"10.1093","volume":"78","author":[{"given":"Miaomiao","family":"Li","sequence":"first","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC) , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing 102206 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang","family":"Song","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC) , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing 102206 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Hu","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC) , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing 102206 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aobo","family":"Dong","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC) , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing 102206 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruihua","family":"Kang","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC) , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing 102206 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Feng","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC) , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing 102206 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hui","family":"Xing","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC) , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing 102206 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuhua","family":"Ruan","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC) , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing 102206 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4177-6038","authenticated-orcid":false,"given":"Yiming","family":"Shao","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC) , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing 102206 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kunxue","family":"Hong","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC) , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing 102206 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lingjie","family":"Liao","sequence":"additional","affiliation":[{"name":"National Center for AIDS\/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC) , Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing 102206 , China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2023,9,28]]},"reference":[{"year":"2016","author":"WHO","key":"2023110823044608500_dkad297-B1"},{"year":"2022","author":"UNAIDS","key":"2023110823044608500_dkad297-B2"},{"key":"2023110823044608500_dkad297-B3","first-page":"5","article-title":"Progress towards the 90-90-90 targets for controlling HIV\u2014China, 2018","volume":"1","author":"Zhao","year":"2019","journal-title":"China CDC Wkly"},{"key":"2023110823044608500_dkad297-B4","doi-asserted-by":"crossref","first-page":"1868068291","DOI":"10.1177\/2325958219831714","article-title":"The benefits of immediate ART","volume":"18","author":"Zhao","year":"2019","journal-title":"J Int Assoc Provid AIDS Care"},{"key":"2023110823044608500_dkad297-B5","first-page":"642","article-title":"Progress on national antiretroviral treatment program during 2003\u20132021 in 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