The HIV-1 epidemic in Brazil has been growing in northeast and north regions, particularly an increase in AIDS cases among the younger male population has been observed. This study aims to characterize the HIV-1 genetic diversity and to evaluate its antiretroviral resistance profile among individuals presenting virological failure in the state of Maranhão—Brazil. HIV-1 pol gene sequences from 633 patients on antiretroviral therapy were obtained from the Department of Surveillance, Prevention and Control of Sexually Transmitted Infections, HIV/AIDS and Viral Hepatitis of the Brazilian Ministry of Health. Phylogenetic and recombination analyses were performed to characterize viral genetic diversity. The presence of antiretroviral resistance mutations was assessed using the HIV Drug Resistance Database online platform of Stanford University. A predominance of subtype B (84.5%) was observed, followed by recombinant BF (9.5%), where more than half of the sequences were dispersed in 3 clusters. Antiretroviral resistance was detected in 74.1% of the sequences, and it was significantly higher for nucleoside analogue reverse-transcriptase inhibitors (NRTIs) than for non-nucleoside analogue reverse-transcriptase inhibitors (NNRTIs) and protease inhibitors (PIs). Inference of putative transmissions clusters identified 11 clusters with 22 query sequences (22/633, 3.5%). Thus, we conclude that continuous monitoring of the molecular epidemiology of HIV-1 is essential for prevention strategies, epidemic control, and treatment adequacy.

巴西的HIV-1流行病在东北和北部地区呈上升趋势，尤其是在年轻男性人群中，艾滋病病例有所增加。这项研究旨在表征HIV-1遗传多样性，并评估在马拉尼昂-巴西州出现病毒学失败的个体中其抗逆转录病毒耐药性。HIV- 1pol来自巴西卫生部监视，预防和控制性传播感染，HIV / AIDS和病毒性肝炎的633例接受抗逆转录病毒治疗的患者的基因序列。进行了系统发育和重组分析以表征病毒遗传多样性。使用斯坦福大学的HIV耐药数据库在线平台评估了抗逆转录病毒耐药性突变的存在。观察到主要是B亚型（84.5％），其次是重组BF（9.5％），其中一半以上的序列分散在3个簇中。在74.1％的序列中检测到抗逆转录病毒耐药性，核苷类似物逆转录酶抑制剂（NRTIs）明显高于非核苷类似物逆转录酶抑制剂（NNRTIs）和蛋白酶抑制剂（PIs）。推定传输群集的推论确定了具有22个查询序列的11个群集（22 / 633，3.5％）。因此，我们得出结论，持续监测HIV-1的分子流行病学对于预防策略，流行病控制和治疗充分性至关重要。