{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T05:05:53Z","timestamp":1789103153327,"version":"build-2803163510"},"reference-count":46,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T00:00:00Z","timestamp":1788912000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"OCP Fondation","award":["INH\u2013UM6P, 2023\u20132025"],"award-info":[{"award-number":["INH\u2013UM6P, 2023\u20132025"]}]},{"DOI":"10.13039\/501100006319","name":"CNRST","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100006319","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>HIV-1 infection in children remains a major public health challenge, particularly in resource-limited settings where access to antiretroviral therapy (ART) and routine virological monitoring is limited. The emergence of HIV-1 drug resistance mutations (DRMs) compromises treatment efficacy and threatens long-term therapeutic outcomes. A systematic literature review was conducted using PubMed and Scopus to identify studies published from 2014 onward reporting HIV-1 genotypic resistance profiles in children receiving ART. Eligible studies included original research using Sanger sequencing or next-generation sequencing (NGS). Due to substantial methodological heterogeneity in study design, sequencing approaches, patient populations, and outcome reporting, a meta-analysis was not performed. The review therefore provides a narrative synthesis of resistance patterns and subtype distribution. Included studies involved children aged 2.1\u201316 years and sample sizes ranging from 3 to 1080 participants. Resistance mutations were most frequently observed in the NNRTI and NRTI classes, particularly K103N and M184V, whereas protease inhibitor and integrase inhibitor resistance remained less common. HIV-1 subtype distribution showed marked geographic variation, with CRF01_AE predominating in Asia, subtype C in Southern Africa, CRF02_AG and CRF06_cpx in West Africa, and subtype B in Europe and the Americas. These findings highlight the substantial burden of pediatric HIV-1 drug resistance and the need for strengthened surveillance and optimized region-specific treatment strategies.<\/jats:p>","DOI":"10.3390\/pathogens15090958","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T09:24:02Z","timestamp":1788945842000},"page":"958","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["HIV-1 Drug Resistance Mutations in Children: A Systematic Review of Global Genotypic Evidence (2014\u20132026)"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-0921-4944","authenticated-orcid":false,"given":"Ghita","family":"Jouf","sequence":"first","affiliation":[{"name":"Medical Biotechnology Laboratory, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat 10100, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alae Bekkouri","family":"Alami","sequence":"additional","affiliation":[{"name":"Medical Biotechnology Laboratory, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat 10100, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najwa","family":"Maazaz","sequence":"additional","affiliation":[{"name":"Faculty of Medical Sciences (FMS), Mohammed VI Polytechnic University, Benguerir 43150, Morocco"},{"name":"Chemical and Biochemical Sciences (CBS), Mohammed VI Polytechnic University, Benguerir 43150, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1788-719X","authenticated-orcid":false,"given":"Soumia","family":"Benchekroun","sequence":"additional","affiliation":[{"name":"Pediatric Infectious Disease Clinic, Ibn Sina University Hospital, Rabat 10100, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elmir","family":"Elharti","sequence":"additional","affiliation":[{"name":"Virology Department, Institut National d\u2019Hygi\u00e8ne, Rabat 10100, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6234-9986","authenticated-orcid":false,"given":"Imane","family":"Belbacha","sequence":"additional","affiliation":[{"name":"Virology Department, Institut National d\u2019Hygi\u00e8ne, Rabat 10100, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hassan","family":"Ihazmad","sequence":"additional","affiliation":[{"name":"Virology Department, Institut National d\u2019Hygi\u00e8ne, Rabat 10100, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachid El","family":"Jaoudi","sequence":"additional","affiliation":[{"name":"Medical Biotechnology Laboratory, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat 10100, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3419-5697","authenticated-orcid":false,"given":"Rachid","family":"Benhida","sequence":"additional","affiliation":[{"name":"Chemical and Biochemical Sciences (CBS), Mohammed VI Polytechnic University, Benguerir 43150, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zineb","family":"Rchiad","sequence":"additional","affiliation":[{"name":"CoreLab, Mohammed VI Polytechnic University, Benguerir 43150, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0981-3457","authenticated-orcid":false,"given":"Hicham","family":"Oumzil","sequence":"additional","affiliation":[{"name":"Medical Biotechnology Laboratory, Faculty of Medicine and Pharmacy, Mohammed V University in Rabat, Rabat 10100, Morocco"},{"name":"Chemical and Biochemical Sciences (CBS), Mohammed VI Polytechnic University, Benguerir 43150, Morocco"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1097\/QAI.0000000000002850","article-title":"HIV-1 Treatment Failure, Drug Resistance and Clinical Outcomes in Perinatally-Infected Children and Adolescents Failing 1st-Line Antiretroviral Therapy in Western Kenya","volume":"89","author":"Nyandiko","year":"2022","journal-title":"J. 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