{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,24]],"date-time":"2026-08-24T09:30:25Z","timestamp":1787563825886,"version":"build-2736575974"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100020953","name":"Centers for Diseases Control, Taiwan","doi-asserted-by":"publisher","award":["MOHW114-CDC-C-114-000101"],"award-info":[{"award-number":["MOHW114-CDC-C-114-000101"]}],"id":[{"id":"10.13039\/100020953","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Resistance-associated mutations (RAMs) to second-generation integrase strand-transfer inhibitors (INSTIs) have been increasingly observed among people with HIV (PWH) who experienced virological failure on dolutegravir-based ART. However, data on dolutegravir resistance in the Asia-Pacific region remain limited, and data on RAMs during virological failure while receiving bictegravir-based ART are even more scarce.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this multicentre, retrospective study in Taiwan, PWH with treatment failure on second-generation INSTI-based ART and successful amplification of the integrase gene were included. Data collected included HIV-1 subtypes, plasma viral loads (PVLs), CD4 counts and clinical characteristics. RAMs were identified using the 2025 IAS-USA mutation list and interpreted using the Stanford HIVdb algorithm.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From 2016 to 2022, 73 and 127 PWH experienced treatment failure on bictegravir- and dolutegravir-based ART, respectively, and had successful genotypic resistance testing. Median PVL at failure was 4.7 log10 copies\/mL, and median CD4 count was 225 cells\/mm3, with no significant between-group differences. RAMs to second-generation INSTIs were detected in 5.5% (4\/73) of bictegravir- and 4.8% (6\/127) of dolutegravir-treated individuals (P\u200a=\u200a0.33). Common RAMs included Q148H\/K\/R (3.5%), G140A\/C\/R\/S (3.0%) and R263K (1.5%), with comparable distributions between the two groups. Among eight PWH retained in care, four achieved viral suppression after switching to salvage ART, and four with continuation of INSTI-based ART.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Although RAMs to second-generation INSTIs may be detected during treatment failure, the overall prevalence remains low for both dolutegravir- and bictegravir-based ART. Viral resuppression can be achieved through salvage therapy or continued use of second-generation INSTI-based regimens.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jac\/dkaf488","type":"journal-article","created":{"date-parts":[[2025,12,17]],"date-time":"2025-12-17T12:57:02Z","timestamp":1765976222000},"source":"Crossref","is-referenced-by-count":1,"title":["Resistance to second-generation integrase inhibitors in people with HIV following treatment failure on dolutegravir- or bictegravir-based ART in Taiwan"],"prefix":"10.1093","volume":"81","author":[{"given":"Guan-Jhou","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei ,","place":["Taiwan"]},{"name":"Infection Control Room, Min-Sheng General Hospital , Taoyuan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan-Yao","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Cheng Kung University Hospital , College of Medicine, National Cheng Kung University, Tainan ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mao-Sung","family":"Tsai","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Far Eastern Memorial Hospital , New Taipei City ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Hsi","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch , Hsinchu ,","place":["Taiwan"]},{"name":"Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao-Hui","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Tzu Chi University and Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation , Hualien ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chi-Ying","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch , Yunlin ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo-Huang","family":"Liou","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Hsinchu MacKay Memorial Hospital , Hsinchu ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tung-Che","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Ditmanson Medical Foundation Chia-Yi Christian Hospital , Chiayi ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shih-Ping","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Taichung Veterans General Hospital , Taichung ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li-Shin","family":"Su","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sui-Yuan","family":"Chang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine , Taipei ,","place":["Taiwan"]},{"name":"Department of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7345-0836","authenticated-orcid":false,"given":"Chien-Ching","family":"Hung","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine , Taipei ,","place":["Taiwan"]},{"name":"Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine , Taipei ,","place":["Taiwan"]},{"name":"Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch , Yunlin ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,1,23]]},"reference":[{"key":"2026012305205991600_dkaf488-B1","author":"US Department of Health and Human Services"},{"key":"2026012305205991600_dkaf488-B2","unstructured":"European AIDS Clinical Society (EACS)\n          . 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