Transmitted drug resistance (TDR) in treatment-naive HIV patients can contribute to failure of initial antiretroviral therapy. In Korea, there has been a gradual increase in TDR, but the recent increase in the use of integrase strand transfer inhibitors (INSTIs) could affect TDR trends and INSTI resistance mutations. We evaluated the patterns of TDR in newly diagnosed HIV patients over time from 2011 to 2019. We analyzed the genotypic resistance of strains in 336 patients and sequenced the integrase gene in 71 among 336 subjects. The overall prevalence of TDR was 5.9% (20 of 336 patients), and it showed a tendency to increase over time (5.1% in 2011–2013, 6.1% in 2014–2016, and 7.2% in 2017–2019; p = .3018). Furthermore, non-nucleoside reverse transcriptase inhibitor resistance showed a marginally significant increase over time (1.45% in 2011–2013, 3.48% in 2014–2016, and 6.02% in 2017–2019; p = .0505). Regarding transmitted INSTI resistance mutation, there were no major INSTI resistance mutations but several accessory INSTI resistance mutations and predominant natural polymorphisms. This study shows several significant changes in TDR and suggests the importance of continuous surveillance of TDR and genetic variation in the integrase region.

中文翻译：

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韩国未接受过治疗的 HIV 患者的传播耐药性趋势。

未经治疗的 HIV 患者的传播耐药性 (TDR) 可能导致初始抗逆转录病毒治疗失败。在韩国，TDR 逐渐增加，但最近整合酶链转移抑制剂 (INSTI) 使用的增加可能会影响 TDR 趋势和 INSTI 耐药突变。我们评估了 2011 年至 2019 年间新诊断的 HIV 患者的 TDR 模式。我们分析了 336 名患者中菌株的基因型耐药性，并对 336 名受试者中的 71 名进行了整合酶基因测序。TDR 的总体患病率为 5.9%（336 名患者中的 20 名），并且呈随时间增加的趋势（2011-2013 年为 5.1%，2014-2016 年为 6.1%，2017-2019 年为 7.2%；p = .3018）。此外，非核苷逆转录酶抑制剂耐药性随着时间的推移略有增加（2011-2013 年为 1.45%，2014-2016 年为 3.48%，2017-2019 年为 6.02%；p  = .0505）。INSTI 抗性遗传突变中没有主要的 INSTI 抗性突变，但有几个 INSTI 抗性突变和显着的天然多态性。这项研究显示了 TDR 的几个显着变化，并表明了持续监测 TDR 和整合酶区域遗传变异的重要性。