{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T12:32:16Z","timestamp":1777379536202,"version":"3.51.4"},"reference-count":66,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2019,8,1]],"date-time":"2019-08-01T00:00:00Z","timestamp":1564617600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["AIDS Research and Human Retroviruses"],"published-print":{"date-parts":[[2019,8]]},"abstract":"<jats:p>Trends in resistance to antiretroviral drugs for HIV-1 may inform clinical support and drug development. We evaluated drug resistance mutation (DRM) trends for nucleoside reverse transcriptase inhibitor (NRTI), non-nucleoside reverse transcriptase inhibitor (NNRTI), protease inhibitor (PI), and integrase strand transfer inhibitor (INSTI) in a large U.S. reference laboratory database. DRMs with a Stanford HIV Drug Resistance Database mutation score \u226510 from deidentified subtype B NRTI\/NNRTI\/PI specimens (2006\u20132017; &gt;10,000\/year) and INSTI specimens (2010\u20132017; &gt;1,000\/year) were evaluated. Sequences with NRTI, NNRTI, or PI single- or multiclass DRMs declined from 48.9% to 39.3%. High-level dual- and triple-class resistance declined from 43.3% (2006) to 17.1% (2017), while sequences with only single-class DRMs increased from 40.0% to 52.9%. The prevalence of DRMs associated with earlier treatment regimens declined, while prevalence of some DRMs associated with newer regimens increased. M184V\/I decreased from 48.3% to 29.4%. K103N\/S\/T declined from 42.5% in 2012 to 36.4% in 2017. Rilpivirine and etravirine DRMs E138A\/Q\/R and E138K increased from 4.9% and 0.4% to 9.7% and 1.7%, respectively. Sequences with \u22651 darunavir DRM declined from 18.1% to 4.8% by 2017. INSTI DRM Q148H\/K\/R declined from 39.3% (2010) to 13.8% (2017). Prevalence of elvitegravir-associated DRMs T66A\/I\/K, E92Q, S147G, and the dolutegravir-associated DRM R263K increased. For a subset of patients with serial testing, 50% (2,646\/5,290) of those who initially had no reportable DRM subsequently developed \u22651 DRM for NRTI\/NNRTI\/PI and 49.7% (159\/320) for INSTI. These trends may inform the need for baseline genotypic resistance testing. The detection of treatment-emergent DRMs in serially tested patients confirms the value of genotypic testing following virologic failure.<\/jats:p>","DOI":"10.1089\/aid.2019.0063","type":"journal-article","created":{"date-parts":[[2019,6,6]],"date-time":"2019-06-06T07:27:20Z","timestamp":1559806040000},"page":"698-709","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":22,"title":["Trends in HIV-1 Drug Resistance Mutations from a U.S. Reference Laboratory from 2006 to 2017"],"prefix":"10.1177","volume":"35","author":[{"given":"Ron M.","family":"Kagan","sequence":"first","affiliation":[{"name":"Quest Diagnostics Infectious Disease, San Juan Capistrano, California."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith J.","family":"Dunn","sequence":"additional","affiliation":[{"name":"Janssen Scientific Affairs, LLC, Titusville, New Jersey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregg P.","family":"Snell","sequence":"additional","affiliation":[{"name":"Quest Diagnostics Medical Informatics, Needham, Massachusetts."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Richard E.","family":"Nettles","sequence":"additional","affiliation":[{"name":"Janssen Scientific Affairs, LLC, Titusville, New Jersey."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harvey W.","family":"Kaufman","sequence":"additional","affiliation":[{"name":"Quest Diagnostics Medical Informatics, Needham, Massachusetts."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2019,8]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-135-1-200107030-00005"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199803263381301"},{"key":"e_1_3_3_4_2","first-page":"CD009153","article-title":"Antiretroviral therapy for prevention of HIV transmission in HIV-discordant couples","author":"Anglemyer A","year":"2013","unstructured":"Anglemyer A, , Rutherford GW, , Horvath T, , Baggaley RC, , Egger M, , Siegfried N: Antiretroviral therapy for prevention of HIV transmission in HIV-discordant couples. 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