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Currently, there is no data regarding resistance to INSTI in Angola since Dolutegravir-DTG was included in the first-line ART regimen. Herein, we investigated the HIV-1 genetic diversity and pretreatment drug resistance (PDR) profile against nucleoside\/tide reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and INSTIs, using a next-generation sequencing (NGS) approach with MinION, established to track and survey DRMs in Angola. This was a cross-sectional study comprising 48 newly HIV-diagnosed patients from Luanda, Angola, screened between March 2022 and May 2023. PR, RT, and IN fragments were sequenced for drug resistance and molecular transmission cluster analysis. A total of 45 out of the 48 plasma samples were successfully sequenced. Of these, 10\/45 (22.2%) presented PDR to PIs\/NRTIs\/NNRTIs. Major mutations for NRTIs (2.2%), NNRTIs (20%), PIs (2.2%), and accessory mutations against INSTIs (13.3%) were detected. No major mutations against INSTIs were detected. M41L (2%) and I85V (2%) mutations were detected for NRTI and PI, respectively. K103N (7%), Y181C (7%), and K101E (7%) mutations were frequently observed in NNRTI. The L74M (9%) accessory mutation was frequently observed in the INSTI class. HIV-1 pure subtypes C (33%), F1 (17%), G (15%), A1 (10%), H (6%), and D (4%), CRF01_AG (4%) were observed, while about 10% were recombinant strains. About 31% of detected HIV-1C sequences were in clusters, suggesting small-scale local transmission chains. No major mutations against integrase inhibitors were detected, supporting the continued use of INSTI in the country. Further studies assessing the HIV-1 epidemiology in the era of INSTI-based ART regimens are needed in Angola.<\/jats:p>","DOI":"10.1038\/s41598-024-66905-1","type":"journal-article","created":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T06:02:02Z","timestamp":1720591322000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["HIV-1 diversity and pre-treatment drug resistance in the era of integrase inhibitor among newly diagnosed ART-na\u00efve adult patients in Luanda, Angola"],"prefix":"10.1038","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1232-0119","authenticated-orcid":false,"given":"Cruz S.","family":"Sebasti\u00e3o","sequence":"first","affiliation":[]},{"given":"Ana B.","family":"Abecasis","sequence":"additional","affiliation":[]},{"given":"Domingos","family":"Jandondo","sequence":"additional","affiliation":[]},{"given":"Joana M. 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The impact of HIV-1 within-host evolution on transmission dynamics. Curr. Opin. Virol. 28, 92\u2013101 (2018).","journal-title":"Curr. Opin. Virol."},{"key":"66905_CR2","doi-asserted-by":"publisher","first-page":"1637","DOI":"10.1097\/QAD.0000000000001536","volume":"31","author":"M Moreno","year":"2017","unstructured":"Moreno, M. et al. HIV drug resistance in Africa: An emerging problem that deserves urgent attention. AIDS 31, 1637\u20131639 (2017).","journal-title":"AIDS"},{"key":"66905_CR3","unstructured":"WHO. HIV Drug Resistance Hiv Drug Resistance Report 2021 (2021)."},{"key":"66905_CR4","first-page":"1","volume":"3099","author":"J Hemelaar","year":"2018","unstructured":"Hemelaar, J. et al. Global and regional molecular epidemiology of HIV-1, 1990\u20132015: A systematic review, global survey, and trend analysis. Lancet Infcet Dis. 3099, 1\u201313 (2018).","journal-title":"Lancet Infcet Dis."},{"key":"66905_CR5","unstructured":"UNAIDS. 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