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Updated: May 28, 2025
An Affordable HIV-1 Drug Resistance Monitoring Method for Resource Limited Settings
Published on: March 30, 2014
Prevalence of Naturally Occurring HIV-1 Capsid Inhibitor Resistance-Related Mutations in Antiretroviral Therapy-Naïve
Nan-Yu Chen1, Chien-Yu Cheng2, Shih-Hao Lo3
1Linkou Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Background:
It is generally believed that HIV-1 capsid inhibitor-naïve populations are susceptible to capsid inhibitors. Moreover, conventional HIV-1 resistance genotyping does not include the CA region, leading to limited surveillance data.
Methods:
We conducted a retrospective study to investigate the presence of mutations at positions associated with capsid inhibitor resistance before the introduction of the first HIV-1 capsid inhibitor, lenacapavir, in Taiwan. Capsid mutations at positions L56, N57, M66, Q67, K70, N74, A105, and T107 were analyzed using a local HIV-1 database that encompasses near-full-length next-generation sequencing data of both antiretroviral therapy (ART)-naïve and -experienced individuals with HIV-1, collected between 2017 and 2023 in Northern Taiwan.
Results:
A total of 287 CA sequences were analyzed. Mutations at positions associated with capsid inhibitor resistance were rare, found in 4.5% (7/156) of ART-naïve and 5.3% (7/131) of ART-experienced individuals, mainly as accessory mutations or polymorphisms. Notably, a Q67H mutation was found in an ART-naïve individual at a frequency of 26.8%, while a Q67R mutation, with unclear clinical implications, appeared at 2.8% in an ART-experienced case.
Conclusions:
This result indicated low prevalence yet undeniable existence of naturally occurring capsid inhibitor resistance-related mutations in capsid inhibitor-naïve individuals with HIV-1.
