{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T03:05:21Z","timestamp":1792292721958,"version":"4.4.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T00:00:00Z","timestamp":1729555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100005564","name":"Gilead Sciences Inc","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100005564","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Second-generation integrase strand transfer inhibitors (InSTIs) have a high barrier to resistance and potent antiretroviral activity. They are recommended as first- or second-line (FL and SL) options in two- and three-drug regimens (2DR and 3DR) in international treatment guidelines. However, there are limited real-world data on emerging resistance at the time of virological failure (VF) with these regimens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The Virostar-1 study objective is to analyse the emergence of resistance-associated mutations (RAMs) over 3\u2005years with DTG-based 2DRs and DTG- or bictegravir (BIC)-based 3DRs in people living with HIV (PLWH) experiencing a VF (FL or SL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Retrospective analysis of genotypic resistance detected at the time of a FL or SL VF with BIC\/FTC\/TAF, DTG\/ABC\/3TC, DTG\/3TC and DTG\/RPV between 2019 and 2022 was conducted from a French multicentre database. VF was defined as two consecutive HIV-1 plasma viral loads &amp;gt; 50\u2005c\/mL. Sanger assays were performed at VF within standard clinical care. Resistance mutations were reported using the ANRS algorithm. Selection biases prevent group comparisons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During the period, N\u200a=\u200a5986 PLWH were followed either in FL or SL. The VF rate was overall low: BIC\/FTC\/TAF, 6.8%; DTG\/ABC\/3TC, 7.5%; DTG\/3TC, 5.1%; and DTG\/RPV, 2.1%. Some emergent InSTI or NRTI RAMs were detected with BIC\/FTC\/TAF 4%, DTG\/ABC\/3TC 8.5%, DTG\/3TC 18% and 39% emergent NNRTI RAMs with DTG\/RPV. However, a complete absence of dual resistance against NRTIs and InSTIs was observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We detected rare emergent InSTI RAMs and few emergent NRTI RAMs in PLWH failing DTG- or BIC-based regimens in FL or SL. The observed rates of emergent RAMs at VF were 4% with BIC\/FTC\/TAF, 8.5% with DTG\/ABC\/3TC, 18% with DTG\/3TC and 39% with DTG\/RPV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkae377","type":"journal-article","created":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T15:29:49Z","timestamp":1729178989000},"page":"95-101","source":"Crossref","is-referenced-by-count":15,"title":["Emergent resistance-associated mutations at first- or second-line HIV-1 virologic failure with second-generation InSTIs in two- and three-drug regimens: the Virostar-1 study"],"prefix":"10.1093","volume":"80","author":[{"given":"Anne-Genevi\u00e8ve","family":"Marcelin","sequence":"first","affiliation":[{"name":"Sorbonne Universit\u00e9, INSERM, Pierre Louis Institute of Epidemiology and Public Health, AP-HP, H\u00f4pital Piti\u00e9-Salp\u00eatri\u00e8re , Laboratoire de Virologie, Paris 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