EuResist NetworkZhou, JinruAbecasis, Ana B.2025-03-132025-03-132024-111999-4915PURE: 112587087PURE UUID: 4b2a7ae7-0980-4a81-aef7-1e8fee09c6dbScopus: 85210451085WOS: 001366566700001PubMed: 39599830PubMedCentral: PMC11599002http://hdl.handle.net/10362/180594Funding Information: This work was funded by a grant from the National Institutes of Health: 2R24AI13661806. The funder played no role in this review. Publisher Copyright: © 2024 by the authors.Introduction: Few data are currently available on the nonnucleoside reverse transcriptase (RT) inhibitors (NNRTI) resistance mutations selected in persons living with HIV-1 (PLWH) who develop virological failure while receiving rilpivirine (RPV). Methods: We analyzed pooled HIV-1 RT genotypic data from 280 PLWH in the multicenter EuResist database and 115 PLWH in the Stanford HIV Drug Resistance Database (HIVDB) who received RPV as their only NNRTI. Results: Among the 395 PLWH receiving RPV, 180 (45.6%) had one or more NNRTI-associated DRMs. Overall, 44 NNRTI-associated DRMs were identified, including 26 that occurred in two or more PLWHs. Seven mutations had a prevalence ≥10% among the 180 PLWH with one or more NNRTI-associated DRM: E138K (32.2%), V90I (25.0%), K101E (17.8%), Y181C (17.2%), E138A (13.9%), H221Y (12.2%), and K103N (10.6%). Y181C was significantly more likely to co-occur with K101E, V179F, H221Y, and M230L. Ten novel non-polymorphic mutations at known NNRTI-associated mutation positions were also identified, usually in just one PLWH: L100F, V108A, T139I, P225S, M230V, Y232C, and T240A/I/M/S. Conclusions: Our analysis extends the spectrum of mutations emerging in PLWH receiving RPV. Additional phenotypic characterization of RPV-selected mutations is necessary to better understand their biological and possible clinical significance.255955engHIV-1 drug resistancenon-nucleoside reverse transcriptase inhibitorsrilpivirineInfectious DiseasesVirologySDG 3 - Good Health and Well-beingjournal article10.3390/v16111715https://www.scopus.com/pages/publications/85210451085