{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T03:08:51Z","timestamp":1773198531431,"version":"3.50.1"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Yunnan Province remains a region with a high prevalence of human immunodeficiency virus (HIV) in China. Due to shared transmission routes, HIV\/Hepatitis C virus (HCV) co-infection is common. This study aimed to analyze the prevalence and mutation patterns of HIV-1 drug resistance among HIV\/HCV co-infected patients specifically following the virological failure of first-line highly active antiretroviral therapy (HAART) in Yunnan, and to compare these characteristics with HIV-1 mono-infected patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A cross-sectional study was conducted among 104 HIV\/HCV co-infected and 120 HIV-1 mono-infected patients who experienced virological failure (HIV-RNA\\geq 1,000 copies\/mL) after at least 6 months of ART. Genotypic drug resistance was tested using an in-house method and analyzed via the Stanford HIV drug resistance database. Multivariable logistic regression and stratified analysis were performed to adjust for confounders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among patients with treatment failure, the drug resistance rate in the HIV\/HCV co-infection group (37.5%) was significantly lower than in the HIV-1 mono-infection group (55.0%,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.009). Multivariable logistic regression showed that HIV\/HCV co-infection was associated with a lower trend of resistance, although it did not reach formal statistical significance after adjusting for gender, treatment duration, and CD4 + Count (aOR = 0.49,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.084). However, stratified analysis revealed that co-infection was significantly associated with lower resistance in patients with a treatment duration of 6\u201312 months (OR = 0.24,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.001) and those with CD4 + Count \u2264 350 cells\/\u03bcL (OR = 0.38,\n                      <jats:italic>P<\/jats:italic>\n                      = 0.001). The frequency of the NRTI-related mutation T69D\/N\/S was significantly lower in the co-infected group (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.029).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Among patients experiencing virological failure, HIV\/HCV co-infection is associated with distinct genotypic resistance profiles, particularly in the early stages of treatment failure and among immunodeficient individuals. These findings suggest that co-infection status may influence the pathway to HIV drug resistance. Clinicians should prioritize prompt genotype resistance testing for co-infected patients failing ART to optimize second-line regimen adjustments.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2026.1715352","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T06:43:57Z","timestamp":1773125037000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["HIV-1 drug resistance among HIV\/HCV co-infected patients with treatment failure in Yunnan, southwestern China: a cross-sectional study"],"prefix":"10.3389","volume":"17","author":[{"given":"Huan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, The First Affiliated Hospital of Kunming Medical University, Kunming","place":["Yunnan, China"]},{"name":"Yunnan Province Clinical Research Center for Laboratory Medicine, Kunming","place":["Yunnan, China"]},{"name":"Yunnan Key Laboratory of Laboratory Medicine, Kunming","place":["Yunnan, China"]},{"name":"Kunming Medical University, Kunming","place":["Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaobo","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The First Affiliated Hospital of Kunming Medical University, Kunming","place":["Yunnan, China"]},{"name":"Yunnan Key Laboratory of Laboratory Medicine, Kunming","place":["Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ya","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The First Affiliated Hospital of Kunming Medical University, Kunming","place":["Yunnan, China"]},{"name":"Yunnan Province Clinical Research Center for Laboratory Medicine, Kunming","place":["Yunnan, China"]},{"name":"Yunnan Key Laboratory of Laboratory Medicine, Kunming","place":["Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chenglu","family":"He","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The First Affiliated Hospital of Kunming Medical University, Kunming","place":["Yunnan, China"]},{"name":"Yunnan Province Clinical Research Center for Laboratory Medicine, Kunming","place":["Yunnan, China"]},{"name":"Yunnan Key Laboratory of Laboratory Medicine, Kunming","place":["Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang","family":"Zou","sequence":"additional","affiliation":[{"name":"Yunnan Province Clinical Research Center for Laboratory Medicine, Kunming","place":["Yunnan, China"]},{"name":"Yunnan Key Laboratory of Laboratory Medicine, Kunming","place":["Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xilin","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, Yan\u2019an Affiliated Hospital of Kunming Medical University, Kunming","place":["Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Zhong","sequence":"additional","affiliation":[{"name":"Department of Clinical Laboratory, The First Affiliated Hospital of Kunming Medical University, Kunming","place":["Yunnan, China"]},{"name":"Yunnan Province Clinical Research Center for Laboratory Medicine, Kunming","place":["Yunnan, China"]},{"name":"Yunnan Key Laboratory of Laboratory Medicine, Kunming","place":["Yunnan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,3,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"470","DOI":"10.1590\/0037-8682-0450-2016","article-title":"Profile of HIV subtypes in HIV\/HBV- and HIV\/HCV-coinfected patients in Southern Brazil.","volume":"50","author":"Avanzi","year":"2017","journal-title":"Rev. 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