Acquired drug-resistant mutation prevalence in ART-treated patients
The DRM prevalence was compared between ART-naïve (N = 222) and ART-treated groups (N = 53) at Severance Hospital (Figure 4) to evaluate the percentage of transmitted drug resistance mutations (TDRM) and acquired drug resistance mutations to four classes of antiretroviral drugs. The NNRTIs resistance was common in ART-naïve (26.1%) and ART-treated (42.3%) patients. The prevalence of DRM was higher in ART-treated patients: NRTIs (36.5% vs. 6.3%), PIs (9.6% vs. 0.9%), and INSTIs (26.9% vs. 2.7%). These differences were high in dual-class resistance: NRTI + NNRTI (19.2% vs. 3.6%), NRTI + PI (5.8% vs. 0.5%), NNRTI + PI (9.6% vs. 0.5%), NRTI + INSTI (21.2% vs. 1.4%), and NNRTI + INSTI (15.4% vs. 1.4%).
Additionally, 428 samples collected from 172 patients revealed that the median observation time was 9 months (2–47 months). Comparing the baseline samples of patients to the follow-up samples, all DRM types (low-level, intermediate, and high-level mutations) increased from 44.2% to 51.6%. The high-level mutations increased from 24.4% to 28.9% (Supplementary Table 5).