{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T06:10:34Z","timestamp":1784268634807,"version":"3.55.0"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"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>Early diagnosis and immediate antiretroviral therapy (ART) for acute and early HIV-1 infection (AEHI) effectively curb HIV transmission and restrict viral reservoir formation. However, subtype-specific transmitted drug resistance (TDR) and early ART virological response remain insufficiently characterized among circulating HIV-1 recombinants in the Guangdong-Hong Kong-Macao Greater Bay Area. This study aimed to compare these key indicators across different HIV-1 subtypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This hospital-based cohort study enrolled 105 AEHI patients from 2019 to 2024. HIV-1 pol gene sequencing was performed for subtype classification and drug resistance genotyping. Antiretroviral therapy responses were monitored at weeks 4, 12, 24, and 48. Demographic, clinical, virological, immunological, and TDR data were systematically analyzed across all HIV-1 subtypes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CRF07_BC was the dominant strain (32.4%), followed by other BC recombinants (30.5%) and CRF01_AE (22.9%). Poppers use was significantly associated with CRF07_BC transmission among MSM (\n                      <jats:italic>P<\/jats:italic>\n                      = 0.007). The B+CRF01_AE\/CRF55_01B group exhibited an extremely high TDR rate of 90.9% (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.001), dominated by V179E and M184V mutations. At weeks 12 and 24 post-ART, BC recombinants and B+CRF01_AE\/CRF55_01B showed slower viral suppression than CRF07_BC, while all subtypes achieved comparable long-term immune recovery (92.6% virological suppression at week 48).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Significant heterogeneity in TDR and early viral load suppression exists among HIV-1 subtypes during acute infection. Baseline drug resistance testing and intensified viral load monitoring are recommended for patients with B\/CRF01_AE recombinant strains. These findings support regional HIV molecular surveillance and subtype-targeted early intervention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmicb.2026.1878265","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T05:42:45Z","timestamp":1784266965000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of clinical characteristics in acute and early HIV-1 infection across different subtypes: a hospital-based cohort study"],"prefix":"10.3389","volume":"17","author":[{"given":"Shanshan","family":"Tang","sequence":"first","affiliation":[{"name":"People\u2019s Hospital of Naxi District, Luzhou","place":["Sichuan, China"]},{"name":"Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou","place":["Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tianyang","family":"Liu","sequence":"additional","affiliation":[{"name":"Institute for Hepatology, National Clinical Research Center for Infectious Diseases, Shenzhen Third People\u2019s Hospital, Shenzhen","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zifan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou","place":["Sichuan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingdan","family":"Gong","sequence":"additional","affiliation":[{"name":"Institute for Hepatology, National Clinical Research Center for Infectious Diseases, Shenzhen Third People\u2019s Hospital, Shenzhen","place":["Guangdong, China"]},{"name":"Department of Microbiology, School of Basic Medical Sciences, Harbin Medical University, Heilongjiang Provincial Key Laboratory of Infection and Immunity","place":["Harbin, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yao","family":"Wang","sequence":"additional","affiliation":[{"name":"Institute for Hepatology, National Clinical Research Center for Infectious Diseases, Shenzhen Third People\u2019s Hospital, Shenzhen","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowen","family":"Li","sequence":"additional","affiliation":[{"name":"Institute for Hepatology, National Clinical Research Center for Infectious Diseases, Shenzhen Third People\u2019s Hospital, Shenzhen","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiuyue","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shenzhen Third People\u2019s Hospital, Shenzhen","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuxiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shenzhen Third People\u2019s Hospital, Shenzhen","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongzhou","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shenzhen Third People\u2019s Hospital, Shenzhen","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lukun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shenzhen Third People\u2019s Hospital, Shenzhen","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun","family":"He","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Shenzhen Third People\u2019s Hospital, Shenzhen","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lanlan","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, The Affiliated Hospital of Southwest Medical University, Luzhou","place":["Sichuan, China"]},{"name":"Institute for Hepatology, National Clinical Research Center for Infectious Diseases, Shenzhen Third People\u2019s Hospital, Shenzhen","place":["Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"10909","DOI":"10.3390\/ijms262210909","article-title":"The origins and genetic diversity of HIV-1: Evolutionary insights and global health perspectives.","volume":"26","author":"Alexiev","year":"2025","journal-title":"Int. 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