{"doi":"10.3390/pathogens14010048","title":"HIV Drug Resistance Profile in Clients Experiencing Treatment Failure After the Transition to a Dolutegravir-Based First-Line Antiretroviral Treatment Regimen in Mozambique","abstract":"<jats:p>Real-world data on HIV drug resistance (HIVDR) after transitioning to tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD) are limited. We assessed HIVDR rates and patterns in clients with virological failure (VF) after switching from an NNRTI-based regimen to TLD. A cross-sectional study was conducted in Gaza, Mozambique (August 2021–February 2022), including adults on first-line ART for ≥12 months who transitioned to TLD and had unsuppressed viral load (VL) ≥ 1000 copies/mL six months post-transition. After three adherence counseling sessions, participants with VF underwent genotyping for drug resistance mutations (DRMs) using the Stanford HIVdb Program. Of 717 participants (median age 39.2 years, 70.7% female), 217 (30.2%) had VF, 193 (88.9%) underwent genotyping, with 183 (94.8%) successfully genotyped. Intermediate–high dolutegravir (DTG) resistance was found in 19.6% (36/183). Unsuppressed VL before DTG transition was independently associated with VF (aOR: 2.14). Resistance patterns included 33.3% (12/36; 95% CI: 14.6–46.3) to all three TLD drugs, 55.6% (20/36; 95% CI: 39.3–71.9) to DTG and 3TC, and 11% (4/36; 95% CI: 0.8–21.3) to DTG only. Major drug resistance mutations to DTG included G118R (9.3%), R263K (6.6%), and Q148H/R/K (4.4%). This study highlights the need to consider virologic status before transitioning PLHIV to TLD and suggests that adherence counseling may not prevent resistance in those with unknown or prior VF.</jats:p>","journal":"Pathogens","year":2025,"id":609049,"datarank":0.5394835166203282,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"self_citation_contribution":0.31191623125197543,"citation_network_contribution":0.2275672853683528,"self_endowment_contribution":0.31191623125197543,"citer_contribution":0.2275672853683528,"corpus_percentile":null,"corpus_rank":null,"citation_count":7,"citer_count":7,"citers_with_citation_signal":5,"citers_with_endowment":5,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1565029,"name":"Cidia Hussein","orcid":null,"position":1,"is_corresponding":false},{"id":1565030,"name":"Cacildo Magul","orcid":"0009-0008-1537-2137","position":2,"is_corresponding":false},{"id":1565032,"name":"Humberto Inguane","orcid":null,"position":3,"is_corresponding":false},{"id":525934,"name":"Aleny Couto","orcid":null,"position":4,"is_corresponding":false},{"id":1565035,"name":"Amancio Nhangave","orcid":null,"position":5,"is_corresponding":false},{"id":1157893,"name":"Ana Muteerwa","orcid":null,"position":6,"is_corresponding":false},{"id":1565039,"name":"Mahoudo Bonou","orcid":"0009-0004-6017-3082","position":7,"is_corresponding":false},{"id":1565042,"name":"Artur Ramos","orcid":"0009-0008-4803-1611","position":8,"is_corresponding":false},{"id":1565045,"name":"Peter Wesley Young","orcid":null,"position":9,"is_corresponding":false},{"id":1565048,"name":"Sonia Chilundo","orcid":null,"position":10,"is_corresponding":false},{"id":271212,"name":"Rhoderick Machekano","orcid":"0000-0002-3433-2551","position":11,"is_corresponding":false},{"id":364590,"name":"Lauren Greenberg","orcid":"0000-0003-1554-0408","position":12,"is_corresponding":false},{"id":335127,"name":"Juliana da Silva","orcid":"0000-0002-1089-6766","position":13,"is_corresponding":false},{"id":437701,"name":"Nilesh Bhatt","orcid":"0000-0002-8389-7786","position":14,"is_corresponding":false},{"id":943141,"name":"Nália Ismael","orcid":"0000-0003-1793-9471","position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"HIV Drug Resistance Profile in Clients Experiencing Treatment Failure After the Transition to a Dolutegravir-Based First-Line Antiretroviral Treatment Regimen in Mozambique","abstract":"<jats:p>Real-world data on HIV drug resistance (HIVDR) after transitioning to tenofovir disoproxil fumarate/lamivudine/dolutegravir (TLD) are limited. We assessed HIVDR rates and patterns in clients with virological failure (VF) after switching from an NNRTI-based regimen to TLD. A cross-sectional study was conducted in Gaza, Mozambique (August 2021–February 2022), including adults on first-line ART for ≥12 months who transitioned to TLD and had unsuppressed viral load (VL) ≥ 1000 copies/mL six months post-transition. After three adherence counseling sessions, participants with VF underwent genotyping for drug resistance mutations (DRMs) using the Stanford HIVdb Program. Of 717 participants (median age 39.2 years, 70.7% female), 217 (30.2%) had VF, 193 (88.9%) underwent genotyping, with 183 (94.8%) successfully genotyped. Intermediate–high dolutegravir (DTG) resistance was found in 19.6% (36/183). Unsuppressed VL before DTG transition was independently associated with VF (aOR: 2.14). Resistance patterns included 33.3% (12/36; 95% CI: 14.6–46.3) to all three TLD drugs, 55.6% (20/36; 95% CI: 39.3–71.9) to DTG and 3TC, and 11% (4/36; 95% CI: 0.8–21.3) to DTG only. Major drug resistance mutations to DTG included G118R (9.3%), R263K (6.6%), and Q148H/R/K (4.4%). This study highlights the need to consider virologic status before transitioning PLHIV to TLD and suggests that adherence counseling may not prevent resistance in those with unknown or prior VF.</jats:p>","is_dataset_classified":null,"base_score":2.0794415416798357,"endowment":2.0794415416798357,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"39861009","pmcid":"PMC11769524","openalex_id":"https://openalex.org/W4406218132","authors":[],"funders":[{"funder_name":"U.S. President’s Emergency Plan for AIDS Relief (PEPFAR)","grant_id":"#NU2GGH001945","title":null}],"total_grants":1,"fwci":4.8467,"citation_percentile":0.947782,"influential_citations":0,"citation_trend":[{"year":2023,"count":1},{"year":2025,"count":5},{"year":2026,"count":1}],"oa_status":"gold","license":"cc-by","oa_locations":[{"url":"https://www.mdpi.com/2076-0817/14/1/48/pdf?version=1736410151","host_type":"journal"},{"url":"https://www.mdpi.com/2076-0817/14/1/48/pdf?version=1736410151","host_type":"publisher"},{"url":"https://www.mdpi.com/2076-0817/14/1/48/pdf","host_type":"publisher"},{"url":"https://doi.org/10.3390/pathogens14010048","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/39861009","host_type":"repository"},{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11769524","host_type":"repository"},{"url":"https://doaj.org/article/7ce3f032172849fb98fbf20eb906afb8","host_type":"repository"},{"url":"https://dx.doi.org/10.3390/pathogens14010048","host_type":"repository"},{"url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC11769524/pdf/pathogens-14-00048.pdf","host_type":"repository"},{"url":"https://europepmc.org/articles/PMC11769524","host_type":"Europe_PMC"},{"url":"https://europepmc.org/articles/PMC11769524?pdf=render","host_type":"Europe_PMC"}],"fields_of_study":["HIV/AIDS drug development and treatment","HIV/AIDS Research and Interventions","HIV Research and Treatment","Humans","Pyridones","Heterocyclic Compounds, 3-Ring","HIV Infections","Male","Oxazines","Drug Resistance, Viral","Adult","Female","Piperazines","Cross-Sectional Studies","Treatment Failure","Middle Aged","Mozambique","Anti-HIV Agents","Viral Load","HIV-1","Genotype","Mutation","Dolutegravir"],"mesh_terms":["Dolutegravir","Adult","Cross-Sectional Studies","Female","Genotype","Heterocyclic Compounds, 3-Ring","Humans","Male","Middle Aged","Mozambique","Mutation","Oxazines","Piperazines","Pyridones","HIV-1","HIV Infections","Treatment Failure","Anti-HIV Agents","Viral Load","Drug Resistance, Viral"],"keywords":["Dolutegravir","Regimen","Medicine","HIV drug resistance","Genotyping","Drug resistance","Lamivudine","Viral load","Internal medicine","Antiretroviral therapy","Human immunodeficiency virus (HIV)","Virology","Virus","Genotype","Genetics","Biology","HIV","Mozambique"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-07-31T02:36:22.230886Z","pmid":null,"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":[]}