High frequency of HIV-1 drug resistance among individuals with persistent low-level viremia during first-line antiretroviral therapy in Uganda
BMC Infectious Diseases·
- DOI
- 10.1186/s12879-026-13774-w
- PMID
- 42304252
- PMCID
- —
- OpenAlex
- W7164896188
- Study type
- Cross-sectional study
- Publisher
- Springer Science and Business Media LLC
- Article type
- journal-article
- Integrity
- current
Publication version
This article has a linked preprint
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Open linked preprint →Why this research matters now
The findings suggest that drug resistance genotyping should be considered for individuals on first-line therapy with detectable persistent low-level viremia. Targeted interventions for youth may improve HIV control outcomes.
Structured evidence summary
Research question
The study assessed the prevalence, patterns, and associated factors of HIV drug resistance among individuals on first-line antiretroviral therapy experiencing persistent low-level viremia in Uganda.
Study design
Cross-sectional study enrolling individuals with persistent low-level viremia, defined by two consecutive detectable viral load results between 50 and 999 copies/mL. HIV drug resistance genotyping was performed on successfully amplified samples.
Population and setting
The study enrolled 444 individuals living with HIV who were on first-line antiretroviral therapy in Uganda and experiencing persistent low-level viremia. Genotyping was successful in 67 participants.
Main findings
Drug resistance was detected in 62.7% of genotyped samples. NNRTI mutations were present in 56.7%, NRTI mutations in 43.3%, and dual-class mutations in 38.8%. The most common mutations were M184V, K103N, and G190A. Having a viral load between 500 and 999 copies/mL and being below 25 years of age were significantly associated with drug resistance during persistent low-level viremia.
Public-health relevance
The findings suggest that drug resistance genotyping should be considered for individuals on first-line therapy with detectable persistent low-level viremia. Targeted interventions for youth may improve HIV control outcomes.
Important limitations
Low genotyping success rates represented a major impediment, with only 15.1% of samples successfully genotyped. This summary relies on the supplied single-article abstract and metadata; the original paper is required for decision-grade interpretation of methodology, selection bias, and generalizability.
GIDS interpretation
This article was identified through classifier links to AIDS, Uganda, and Treatment topics. It provides context on drug resistance patterns during persistent low-level viremia but does not constitute surveillance data or establish causal claims beyond the study population.
Related GIDS surveillance
Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.
Evidence relationships
This article has 8 auditable classifier relationships to diseases, places, topics, and study design.