{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T10:59:11Z","timestamp":1771930751880,"version":"3.50.1"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T00:00:00Z","timestamp":1770336000000},"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. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate the prevalence and patterns of drug resistance mutations (DRMs) and associated risk factors among ART-experienced people living with HIV (PLWH) exhibiting low-level viremia (LLV; 50\u2013999 copies\/mL) in Chongqing, China, and to evaluate the utility of a combined plasma RNA and proviral DNA genotyping strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional study (September 2023\u2013February 2024), we screened 4,941 ART-treated individuals, identifying 210 with LLV. Genotypic resistance testing targeting the protease, reverse transcriptase, and integrase regions was successfully performed for 133 participants (63.33%) using a dual-source (plasma RNA and\/or proviral DNA) approach. HIV-1 subtyping and DRM analysis were conducted using the Stanford HIVdb algorithm and phylogenetic methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall prevalence of LLV was 4.25%. CRF07_BC was the predominant HIV-1 subtype (76.69%). DRMs were detected in 26.32% (35\/133) of the cohort. Resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs) was most common (19.55%), primarily driven by V179D\/E and G190A\/S\/E mutations. Resistance to nucleoside reverse transcriptase inhibitors (NRTIs) and integrase strand transfer inhibitors (INSTIs) was observed in 12.03 and 3.76% of participants, respectively, with M184V\/I being the predominant NRTI mutation. No significant differences in DRM prevalence were observed across viral subtypes. In multivariate analysis, baseline CD4\n                      <jats:sup>+<\/jats:sup>\n                      T-cell count &amp;lt;100 cells\/\u03bcL was significantly associated with DRMs specifically in the isolated LLV subgroup.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study reveals a considerable prevalence of drug mutations (DRMs), predominantly against NNRTIs, among ART-experienced PLWH with LLV in Chongqing. The combined RNA\/DNA genotyping strategy significantly enhanced DRM detection sensitivity in this low viral load cohort, underscoring its value for resistance surveillance and guiding clinical management in resource-limited settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1753298","type":"journal-article","created":{"date-parts":[[2026,2,6]],"date-time":"2026-02-06T06:36:19Z","timestamp":1770359779000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Characterization of drug resistance mutations in people living with HIV with low-level viremia on antiretroviral therapy in Chongqing, China"],"prefix":"10.3389","volume":"14","author":[{"given":"Huizheng","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Clinical Laboratory, Chongqing Public Health Medical Center","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Chongqing Public Health Medical Center","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Chongqing General Hospital, Chongqing University","place":["Chongqing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weidong","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Immunology, College of Basic Medical Sciences, Zhengzhou University","place":["Zhengzhou, Henan, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,6]]},"reference":[{"key":"ref1","volume-title":"WHO guidelines approved by the guidelines review committee. 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