{"doi":"10.1093/infdis/jiae131","title":"Impact of Low-Frequency Human Immunodeficiency Virus Type 1 Drug Resistance Mutations on Antiretroviral Therapy Outcomes","abstract":"BACKGROUND: The association between low-frequency HIV-1 drug resistance mutations (DRMs) and treatment failure (TF) is controversial. We explore this association using NGS methods that accurately sample low-frequency DRMs. METHODS: We enrolled women with HIV-1 in Malawi who were either ART naïve (A), had ART failure (B), or had discontinued ART (C). At entry, A and C began an NNRTI-based regimen and B started a PI-based regimen. We used Primer ID MiSeq to identify regimen-relevant DRMs in entry and TF plasma samples, and a Cox proportional hazards model to calculate hazard ratios (HRs) for entry DRMs. Low-frequency DRMs were defined as ≤ 20%. RESULTS: We sequenced 360 participants. Cohort B and C participants were more likely to have TF than Cohort A participants. The presence of K103N at entry significantly increased TF risk among A and C participants at both high and low frequency, with HR of 3.12 [1.58-6.18, 95% CI] and 2.38 [1.00-5.67, 95% CI] respectively. At TF, 45% of participants showed selection of DRMs while in the remaining participants there was an apparent lack of selective pressure from ART. CONCLUSIONS: Using accurate NGS for DRM detection may benefit an additional 10% of the patients by identifying low-frequency K103N mutations.","journal":"The Journal of Infectious Diseases","year":2024,"id":451342,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9543,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2024-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":416700,"name":"Shuntai Zhou","orcid":"0000-0002-8353-386X","position":1,"is_corresponding":false},{"id":1272801,"name":"Claire L Amon","orcid":null,"position":2,"is_corresponding":false},{"id":1104322,"name":"Nathan Long","orcid":"0000-0002-0220-7318","position":3,"is_corresponding":false},{"id":552475,"name":"Collin S Hill","orcid":"0000-0003-3968-1862","position":4,"is_corresponding":false},{"id":109139,"name":"Lily E. Adams","orcid":"0000-0001-7780-9973","position":5,"is_corresponding":false},{"id":406121,"name":"Gerald Tegha","orcid":"0000-0002-7744-5564","position":6,"is_corresponding":false},{"id":597211,"name":"Maganizo Chagomerana","orcid":"0000-0003-4231-4553","position":7,"is_corresponding":false},{"id":944706,"name":"Allan Jumbe","orcid":null,"position":8,"is_corresponding":false},{"id":594110,"name":"Madalitso Maliwichi","orcid":null,"position":9,"is_corresponding":false},{"id":944266,"name":"Shaphil Wallie","orcid":"0000-0003-0042-8157","position":10,"is_corresponding":false},{"id":218325,"name":"Yijia Li","orcid":"0000-0001-5300-0571","position":11,"is_corresponding":false},{"id":247475,"name":"Ronald Swanstrom","orcid":"0000-0001-7777-0773","position":12,"is_corresponding":false},{"id":312050,"name":"Mina C. Hosseinipour","orcid":"0000-0003-2174-313X","position":13,"is_corresponding":false},{"id":1272800,"name":"Rachel M Burdorf","orcid":null,"position":0,"is_corresponding":true}],"reference_count":38,"raw_metadata":null,"created_at":"2026-07-19T02:02:41.417944Z","pmid":"38462671","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}