Rising Concerns of Pretreatment Drug Resistance in HIV/AIDS Therapy

Strategic Insights -

Research conducted in Guangxi, China, from 2019 to 2022 has revealed a significant problem with pretreatment drug resistance (PDR) in HIV/AIDS therapy. The study, led by researchers from Guangxi Medical University, found that the overall prevalence of PDR was 8.4% among newly diagnosed, antiretroviral therapy (ART)-naive individuals. This prevalence was driven by non-nucleoside reverse transcriptase inhibitors (NNRTIs) being the most commonly affected drug class, with the most prevalent NNRTI-associated mutation being E138A (2.4%).

Key Takeaways:

  • The study, conducted in Nanning City, Guangxi, involved 1,260 newly diagnosed, ART-naive individuals with HIV.
  • The overall prevalence of PDR was 8.4%, with non-nucleoside reverse transcriptase inhibitors (NNRTIs) being the most commonly affected drug class.
  • The most prevalent NNRTI-associated mutation was E138A (2.4%), and high-level resistance was primarily observed to efavirenz and nevirapine.
  • The CRF08_BC subtype exhibited significant clustering of PDR-related sequences and was found to be associated with transmission networks clustering.
  • The study identified a moderate prevalence of PDR among newly diagnosed HIV patients in Guangxi, primarily driven by NNRTI-associated resistance mutations.
  • Targeted educational programs on ART adherence and drug resistance awareness should be prioritized, especially among older adults and individuals infected through heterosexual contacts.

Statistics:

  • 8.4% of newly diagnosed, ART-naive individuals had pretreatment drug resistance (PDR).
  • Non-nucleoside reverse transcriptase inhibitors (NNRTIs) were the most commonly affected drug class, with a prevalence of 2.4% for the E138A mutation.
  • 1,048 eligible pol sequences were analyzed.
  • Those individuals diagnosed in 2022 were more likely to have PDR, with a prevalence of 10.3%.
  • Transmission networks clustering was significantly associated with CRF01_AE and CRF08_BC subtypes, older age, and heterosexual transmission.

Sources:

  • Molecular epidemiology and pretreatment drug resistance of HIV-1 among newly diagnosed individuals in Nanning City, Guangxi, China. Microbiology Spectrum, 2025,13(10).
  • NewsRx Reports on HIV/AIDS Findings from Guangxi Medical University Provide New Insights (Molecular epidemiology and pretreatment drug resistance of HIV-1 among newly diagnosed individuals in Nanning City, Guangxi, China). AIDS Weekly. October 20, 2025; p 161.