{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T16:49:53Z","timestamp":1780937393527,"version":"3.54.1"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T00:00:00Z","timestamp":1702339200000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>To evaluate the prevalence of transmitted drug resistance (TDR)\u00a0to nucleoside and nonnucleoside reverse transcriptase inhibitors (NRTI,\u00a0NNRTI),\u00a0protease inhibitors (PI),\u00a0and integrase strand transfer inhibitors (INSTI)\u00a0in Spain during the period 2019\u20132021, as well as to evaluate transmitted clinically relevant resistance (TCRR)\u00a0to antiretroviral drugs. Reverse transcriptase (RT),\u00a0protease (Pro), and Integrase (IN)\u00a0sequences from 1824 PLWH (people living with HIV) were studied. To evaluate TDR we investigated the prevalence of surveillance drug resistance mutations (SDRM).\u00a0To evaluate TCRR (any resistance level\u2009\u2265\u20093), and for HIV subtyping we used the Stanford v.9.4.1 HIVDB Algorithm and an in\u2010depth phylogenetic analysis. The prevalence of NRTI SDRMs was 3.8% (95% CI,\u00a02.8%\u20134.6%), 6.1% (95% CI,\u00a05.0%\u20137.3%) for NNRTI, 0.9% (95% CI,\u00a00.5%\u20131.4%) for PI, and 0.2% (95% CI,\u00a00.0%\u20130.9%) for INSTI. The prevalence of TCRR to NRTI was 2.1% (95% CI,\u00a01.5%\u20132.9%), 11.8% for NNRTI, (95% CI,\u00a010.3%\u201313.5%), 0.2% (95% CI,\u00a00.1%\u20130.6%) for PI, and 2.5% (95% CI,\u00a01.5%\u20134.1%) for INSTI. Most of the patients were infected by subtype B (79.8%), while the majority of non\u2010Bs were CRF02_AG (<jats:italic>n<\/jats:italic>\u2009=\u2009109, 6%). The prevalence of INSTI and PI resistance in Spain during the period 2019\u20132021 is low, while NRTI resistance is moderate, and NNRTI resistance is the highest. Our results support the use of integrase inhibitors as first\u2010line treatment in Spain. Our findings highlight the importance of ongoing surveillance of TDR to antiretroviral drugs in PLWH\u00a0particularly with regard to first\u2010line antiretroviral therapy.<\/jats:p>","DOI":"10.1002\/jmv.29287","type":"journal-article","created":{"date-parts":[[2023,12,12]],"date-time":"2023-12-12T23:38:54Z","timestamp":1702424334000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Transmitted drug resistance to antiretroviral drugs in Spain during the period 2019\u20132021"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1157-4299","authenticated-orcid":false,"given":"Laura","family":"Vi\u00f1uela","sequence":"first","affiliation":[{"name":"Clinical Microbiology Unit Hospital Universitario Cl\u00ednico San Cecilio  Granada Spain"},{"name":"Instituto de Investigaci\u00f3n Ibs  Granada Spain"},{"name":"Ciber de Enfermedades Infecciosas, CIBERINFEC, ISCIII  Madrid 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