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Volume 18
Issue 6
10.3390/v18060685
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This is an early access version, the complete PDF, HTML, and XML versions will be available soon.
Article

Acquired HIV–1 Drug Resistance and Molecular Transmission Networks in Zhongwei, Ningxia, China

by
Youping Duan
1,
Subinuer Mutalifu
1,
Ziyang Luo
1,
Yufeng Li
1,
Xiaohong Zhu
1,
Jianxin Pei
2,
Dongzhi Yang
2 and
Zhonglan Wu
2,3,*
1
College of Public Health, Ningxia Medical University, Yinchuan 750004, China
2
Ningxia Center for Disease Control and Prevention, Yinchuan 750011, China
3
College of Life Sciences, University of Ningxia, Yinchuan 750021, China
*
Author to whom correspondence should be addressed.
Viruses 2026, 18(6), 685; https://doi.org/10.3390/v18060685 (registering DOI)
Submission received: 25 April 2026 / Revised: 15 June 2026 / Accepted: 16 June 2026 / Published: 18 June 2026
(This article belongs to the Section Human Virology and Viral Diseases)
Versions Notes

Abstract

Objective: This retrospective cross–sectional study aimed to characterize HIV–1 genotypes, assess drug resistance, and analyze molecular transmission networks in Zhongwei City to inform prevention strategies. Methods: Plasma samples were collected from antiretroviral therapy (ART)–treated patients (2007–2024) with viral load ≥200 copies/mL. HIV–1 pol was amplified by nested PCR; successful sequences were genotyped by maximum likelihood (ML) (IQ–TREE, TVM+F+I+G4, 1000 bootstrap). Drug resistance (DR) was interpreted using Stanford HIV Drug Resistance Database (HIVDB) v9.0; detected mutations represent acquired drug resistance (ADR). Pairwise genetic distances (GD) (TN93 model) were calculated; transmission networks were constructed in Cytoscape 3.10.3. Results: 75 sequences were obtained. Males (84.00%), and heterosexual transmission (64.00%) predominated. CRF07_BC (46.67%) and CRF01_AE (38.67%) were the major subtypes; the overall ADR rate was 40.00%, mainly NNRTIs–associated (30.67% of all participants, including 16.00% single–class NNRTIs and 14.67% dual–class NRTIs–NNRTIs). Network inclusion rate was 40.00% of the 75 sequences; CRF07_BC showed higher betweenness centrality (p = 0.028), while CRF01_AE and CRF85_BC showed higher closeness centrality (p < 0.001). Occupation significantly affected network enrollment (p ≤ 0.05). Conclusion: HIV–1 subtypes are diverse with high ADR. CRF07_BC may act as a transmission bridge, whereas CRF01_AE and CRF85_BC exhibit faster potential spread. Baseline DR testing and network–guided interventions are recommended.
Keywords: HIV–1; gene subtype; drug resistance; molecular transmission network HIV–1; gene subtype; drug resistance; molecular transmission network

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MDPI and ACS Style

Duan, Y.; Mutalifu, S.; Luo, Z.; Li, Y.; Zhu, X.; Pei, J.; Yang, D.; Wu, Z. Acquired HIV–1 Drug Resistance and Molecular Transmission Networks in Zhongwei, Ningxia, China. Viruses 2026, 18, 685. https://doi.org/10.3390/v18060685

AMA Style

Duan Y, Mutalifu S, Luo Z, Li Y, Zhu X, Pei J, Yang D, Wu Z. Acquired HIV–1 Drug Resistance and Molecular Transmission Networks in Zhongwei, Ningxia, China. Viruses. 2026; 18(6):685. https://doi.org/10.3390/v18060685

Chicago/Turabian Style

Duan, Youping, Subinuer Mutalifu, Ziyang Luo, Yufeng Li, Xiaohong Zhu, Jianxin Pei, Dongzhi Yang, and Zhonglan Wu. 2026. "Acquired HIV–1 Drug Resistance and Molecular Transmission Networks in Zhongwei, Ningxia, China" Viruses 18, no. 6: 685. https://doi.org/10.3390/v18060685

APA Style

Duan, Y., Mutalifu, S., Luo, Z., Li, Y., Zhu, X., Pei, J., Yang, D., & Wu, Z. (2026). Acquired HIV–1 Drug Resistance and Molecular Transmission Networks in Zhongwei, Ningxia, China. Viruses, 18(6), 685. https://doi.org/10.3390/v18060685

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