{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,5]],"date-time":"2026-03-05T07:56:16Z","timestamp":1772697376843,"version":"3.50.1"},"reference-count":49,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T00:00:00Z","timestamp":1681776000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Central Research Institute of Epidemiology","award":["VG-NIR33-F"],"award-info":[{"award-number":["VG-NIR33-F"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>In Russia, antiretroviral therapy (ART) coverage has significantly increased, which, in the absence of routine genotyping testing, could lead to an increase in HIV drug resistance (DR). The aim of this study was to investigate the patterns and temporal trends in HIV DR as well as the prevalence of genetic variants in treatment-na\u00efve patients from 2006 to 2022, using data from the Russian database (4481 protease and reverse transcriptase and 844 integrase gene sequences). HIV genetic variants, and DR and DR mutations (DRMs) were determined using the Stanford Database. The analysis showed high viral diversity, with the predominance of A6 (78.4%), which was the most common in all transmission risk groups. The overall prevalence of surveillance DRMs (SDRMs) was 5.4%, and it reached 10.0% in 2022. Most patients harbored NNRTI SDRMs (3.3%). The prevalence of SDRMs was highest in the Ural (7.9%). Male gender and the CRF63_02A6 variant were association factors with SDRMs. The overall prevalence of DR was 12.7% and increased over time, primarily due to NNRTIs. Because baseline HIV genotyping is unavailable in Russia, it is necessary to conduct surveillance of HIV DR due to the increased ART coverage and DR prevalence. Centralized collection and unified analysis of all received genotypes in the national database can help in understanding the patterns and trends in DR to improve treatment protocols and increase the effectiveness of ART. Moreover, using the national database can help identify regions or transmission risk groups with a high prevalence of HIV DR for epidemiological measures to prevent the spread of HIV DR in the country.<\/jats:p>","DOI":"10.3390\/v15040991","type":"journal-article","created":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T02:30:03Z","timestamp":1681785003000},"page":"991","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["HIV-1 Drug Resistance among Treatment-Na\u00efve Patients in Russia: Analysis of the National Database, 2006\u20132022"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7116-0138","authenticated-orcid":false,"given":"Alina","family":"Kirichenko","sequence":"first","affiliation":[{"name":"Central Research Institute of Epidemiology, 111123 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7896-2379","authenticated-orcid":false,"given":"Dmitry","family":"Kireev","sequence":"additional","affiliation":[{"name":"Central Research Institute of Epidemiology, 111123 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6328-1415","authenticated-orcid":false,"given":"Ilya","family":"Lapovok","sequence":"additional","affiliation":[{"name":"Central Research Institute of Epidemiology, 111123 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1390-8021","authenticated-orcid":false,"given":"Anastasia","family":"Shlykova","sequence":"additional","affiliation":[{"name":"Central Research Institute of Epidemiology, 111123 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2826-699X","authenticated-orcid":false,"given":"Alexey","family":"Lopatukhin","sequence":"additional","affiliation":[{"name":"Central Research Institute of Epidemiology, 111123 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2677-0404","authenticated-orcid":false,"given":"Anastasia","family":"Pokrovskaya","sequence":"additional","affiliation":[{"name":"Central Research Institute of Epidemiology, 111123 Moscow, Russia"},{"name":"Department of Infectious Diseases with Courses of Epidemiology and Phthisiology, Medical Institute, Peoples\u2019 Friendship University of Russia (RUDN University), 117198 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5481-8957","authenticated-orcid":false,"given":"Marina","family":"Bobkova","sequence":"additional","affiliation":[{"name":"Gamaleya National Research Center for Epidemiology and Microbiology, 123098 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anastasiia","family":"Antonova","sequence":"additional","affiliation":[{"name":"Gamaleya National Research Center for Epidemiology and Microbiology, 123098 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5299-3081","authenticated-orcid":false,"given":"Anna","family":"Kuznetsova","sequence":"additional","affiliation":[{"name":"Gamaleya National Research Center for Epidemiology and Microbiology, 123098 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3110-0843","authenticated-orcid":false,"given":"Ekaterina","family":"Ozhmegova","sequence":"additional","affiliation":[{"name":"Gamaleya National Research Center for Epidemiology and Microbiology, 123098 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sergey","family":"Shtrek","sequence":"additional","affiliation":[{"name":"Omsk Research Institute of Natural Focal Infections, 644080 Omsk, Russia"},{"name":"Department of Microbiology, Virology and Immunology, Omsk State Medical University, 644099 Omsk, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksej","family":"Sannikov","sequence":"additional","affiliation":[{"name":"Omsk Research Institute of Natural Focal Infections, 644080 Omsk, Russia"},{"name":"Department of Microbiology, Virology and Immunology, Omsk State Medical University, 644099 Omsk, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Zaytseva","sequence":"additional","affiliation":[{"name":"Academician I.N. Blokhina Nizhny Novgorod Scientific Research Institute of Epidemiology and Microbiology of the Rospotrebnadzor, 603022 Nizhny Novgorod, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olga","family":"Peksheva","sequence":"additional","affiliation":[{"name":"Academician I.N. Blokhina Nizhny Novgorod Scientific Research Institute of Epidemiology and Microbiology of the Rospotrebnadzor, 603022 Nizhny Novgorod, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5506-2389","authenticated-orcid":false,"given":"Michael","family":"Piterskiy","sequence":"additional","affiliation":[{"name":"Federal Scientific Research Institute of Viral Infections \u00abVirome\u00bb Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 620030 Ekaterinburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksandr","family":"Semenov","sequence":"additional","affiliation":[{"name":"Federal Scientific Research Institute of Viral Infections \u00abVirome\u00bb Federal Service for Surveillance on Consumer Rights Protection and Human Wellbeing, 620030 Ekaterinburg, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Galina","family":"Turbina","sequence":"additional","affiliation":[{"name":"Lipetsk Regional Center for Prevention and Control of AIDS and Infectious Diseases, 398043 Lipetsk, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalia","family":"Filoniuk","sequence":"additional","affiliation":[{"name":"Lipetsk Regional Center for Prevention and Control of AIDS and Infectious Diseases, 398043 Lipetsk, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1637-4229","authenticated-orcid":false,"given":"Andrey","family":"Shemshura","sequence":"additional","affiliation":[{"name":"Clinical Center of HIV\/AIDS Treatment and Prevention of the Ministry of Health of Krasnodar Region, 350000 Krasnodar, Russia"},{"name":"Department of Infectious Diseases and Epidemiology, The Faculty of Advanced Training and Professional Retraining of Specialists, Kuban State Medical University of the Ministry of Health of the Russian Federation, 350063 Krasnodar, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeriy","family":"Kulagin","sequence":"additional","affiliation":[{"name":"Clinical Center of HIV\/AIDS Treatment and Prevention of the Ministry of Health of Krasnodar Region, 350000 Krasnodar, Russia"},{"name":"Department of Infectious Diseases and Epidemiology, The Faculty of Advanced Training and Professional Retraining of Specialists, Kuban State Medical University of the Ministry of Health of the Russian Federation, 350063 Krasnodar, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dmitry","family":"Kolpakov","sequence":"additional","affiliation":[{"name":"Rostov Research Institute of Microbiology and Parasitology, 344000 Rostov-on-Don, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksandr","family":"Suladze","sequence":"additional","affiliation":[{"name":"Rostov Research Institute of Microbiology and Parasitology, 344000 Rostov-on-Don, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valeriya","family":"Kotova","sequence":"additional","affiliation":[{"name":"Khabarovsk Research Institute of Epidemiology and Microbiology of the Rospotrebnadzor, 680610 Khabarovsk, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lyudmila","family":"Balakhontseva","sequence":"additional","affiliation":[{"name":"Khabarovsk Research Institute of Epidemiology and Microbiology of the Rospotrebnadzor, 680610 Khabarovsk, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vadim","family":"Pokrovsky","sequence":"additional","affiliation":[{"name":"Central Research Institute of Epidemiology, 111123 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasiliy","family":"Akimkin","sequence":"additional","affiliation":[{"name":"Central Research Institute of Epidemiology, 111123 Moscow, Russia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,18]]},"reference":[{"key":"ref_1","unstructured":"European Centre for Disease Prevention and Control\/WHO Regional Office for Europe (2021). HIV\/AIDS Surveillance in Europe 2021\u20132020 Data, ECDC. Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/hiv-aids-surveillance-europe-2021-2020-data."},{"key":"ref_2","first-page":"12","article-title":"Prevalence of human immune deficiency virus infection in the territories of the Russian Federation in 2021","volume":"12","author":"Ladnaia","year":"2022","journal-title":"Epidemiol. Infect. Dis. Curr. Items"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1056\/NEJM199803263381301","article-title":"Declining morbidity and mortality among patients with advanced human immunodeficiency virus infection","volume":"338","author":"Palella","year":"1998","journal-title":"N. Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1056\/NEJMoa1105243","article-title":"Prevention of HIV-1 infection with early antiretroviral therapy","volume":"365","author":"Cohen","year":"2011","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1097\/QAI.0b013e3182968e87","article-title":"Accuracy of definitions for linkage to care in persons living with HIV","volume":"63","author":"Keller","year":"2013","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Samji, H., Cescon, A., Hogg, R.S., Modur, S.P., Althoff, K.N., Buchacz, K., Burchell, A.N., Cohen, M., Gebo, K.A., and Gill, M.J. (2013). Closing the gap: Increases in life expectancy among treated HIV-positive individuals in the United States and Canada. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0081355"},{"key":"ref_7","unstructured":"Ministry of Health of the Russian Federation (2022, December 01). Clinical Guidelines \u201cHIV Infection in Adults\u201d. (In Russian)."},{"key":"ref_8","unstructured":"Ministry of Health of the Russian Federation (2022, December 01). Clinical Guidelines \u201cHIV Infection in Adults\u201d. (In Russian)."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1811","DOI":"10.1007\/s40265-017-0820-3","article-title":"Elsulfavirine: First global approval","volume":"77","year":"2017","journal-title":"Drugs"},{"key":"ref_10","unstructured":"International Treatment Preparedness Coalition Eastern Europe and Central Asia (2022). Analysis of Procurement of ARV Drugs in the Russian Federation in 2021, ITPC-EECA. (In Russian)."},{"key":"ref_11","unstructured":"Federal Russian AIDS Center (2022, December 01). Report 2006. (In Russian)."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1097\/QAD.0000000000002983","article-title":"The Joint United Nations Programme on HIV\/AIDS 95-95-95 targets: Worldwide clinical and cost benefits of generic manufacture","volume":"35","author":"Heath","year":"2021","journal-title":"AIDS"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.meegid.2016.08.031","article-title":"HIV-1 drug resistance and resistance testing","volume":"46","author":"Clutter","year":"2016","journal-title":"Infect. Genet. Evol."},{"key":"ref_14","unstructured":"(2022, December 01). Standard of Primary Health Care for Adults with HIV Infection. (In Russian)."},{"key":"ref_15","unstructured":"International Treatment Preparedness Coalition Eastern Europe and Central Asia (2022). Analysis of Procurement of Diagnostics for HIV Treatment in Russia in 2020\u20132021, ITPC-EECA. (In Russian)."},{"key":"ref_16","unstructured":"Pokrovskaya, A., Kireev, D., Emerole, K., Kirichenko, A., and Pokrovsky, V. (2022, January 23\u201326). Pilot model of the HIV drug resistance testing coverage cascade. Proceedings of the HIV Glasgow Conference, Glasgow, UK."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Bennett, D.E., Camacho, R.J., Otelea, D., Kuritzkes, D.R., Fleury, H., Kiuchi, M., Heneine, W., Kantor, R., Jordan, M.R., and Schapiro, J.M. (2009). Drug resistance mutations for surveillance of transmitted HIV-1 drug-resistance: 2009 update. PLoS ONE, 4.","DOI":"10.1371\/journal.pone.0004724"},{"key":"ref_18","first-page":"27","article-title":"Analysis of prevalence of HIV-1 primary resistance to antiretroviral drugs in the territory of Moscow and Moscow region","volume":"96","author":"Nosik","year":"2019","journal-title":"J. Microbiol. Epid. Immun."},{"key":"ref_19","first-page":"20","article-title":"Genetic profile and characteristics of HIV-1 drug resistance mutation in the Krasnodar region over the 2014 to 2019","volume":"14","author":"Antonova","year":"2022","journal-title":"HIV Inf. Immunosup. Disord."},{"key":"ref_20","first-page":"75","article-title":"The level and structure of HIV-1 drug resistance among patients with no experience of taking antiretroviral drugs since the start of antiretroviral therapy in the Russian Federation","volume":"11","author":"Kirichenko","year":"2019","journal-title":"HIV Inf. Immunosup. Disord."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Kirichenko, A., Kireev, D., Lopatukhin, A., Murzakova, A., Lapovok, I., Saleeva, D., Ladnaya, N., Gadirova, A., Ibrahimova, S., and Safarova, A. (2022). Prevalence of HIV-1 drug resistance in Eastern European and Central Asian countries. PLoS ONE, 17.","DOI":"10.1371\/journal.pone.0257731"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Kirichenko, A., Lapovok, I., Baryshev, P., van de Vijver, D.A.M.C., van Kampen, J.J.A., Boucher, C.A.B., Paraskevis, D., and Kireev, D. (2020). Genetic Features of HIV-1 Integrase Sub-Subtype A6 Predominant in Russia and Predicted Susceptibility to INSTIs. Viruses, 12.","DOI":"10.3390\/v12080838"},{"key":"ref_23","unstructured":"(2022, December 01). Decree of the Chief State Sanitary Doctor of the Russian Federation of January 28, 2021 N 4 \u201cOn Approval of Sanitary Rules and Norms SanPiN 3.3686-21 \u201cSanitary and Epidemiological Requirements for the Prevention of Infectious Diseases\u201d\u201d. (In Russian)."},{"key":"ref_24","unstructured":"(2022, December 01). Stanford HIV Data Base. Available online: http:\/\/hivdb.stanford.edu."},{"key":"ref_25","unstructured":"The Joint United Nations Programme on HIV\/AIDS (2014). Understanding Fast-Track: Accelerating Action to End the AIDS Epidemic by 2030, UNAIDS. Available online: https:\/\/www.unaids.org\/en\/resources\/documents\/2014\/JC2686_WAD2014report."},{"key":"ref_26","unstructured":"World Health Organization (2017). HIV Drug Resistance Report, WHO. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241512831."},{"key":"ref_27","unstructured":"World Health Organization (2016). HIV Drug Resistance Surveillance Guidance\u20142015 Update, WHO. Available online: https:\/\/apps.who.int\/iris\/handle\/10665\/204471."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1016\/S1473-3099(11)70032-9","article-title":"Effect of transmitted drug resistance on virological and immunological response to initial combination antiretroviral therapy for HIV (EuroCoord-CHAIN joint project): A European multicohort study","volume":"11","author":"Wittkop","year":"2011","journal-title":"Lancet Infect. Dis."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"307","DOI":"10.1016\/S1473-3099(11)70255-9","article-title":"Effect of pretreatment HIV-1 drug resistance on immunological, virological, and drug-resistance outcomes of first-line antiretroviral treatment in sub-Saharan Africa: A multicentre cohort study","volume":"12","author":"Hamers","year":"2012","journal-title":"Lancet Infect Dis."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1362","DOI":"10.1093\/infdis\/jix089","article-title":"Impact of HIV drug resistance on HIV\/AIDS-associated mortality, new infections, and antiretroviral therapy program costs in sub-Saharan Africa","volume":"215","author":"Phillips","year":"2017","journal-title":"J. Infect. Dis."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1093\/cid\/civ963","article-title":"Transmission of HIV Drug Resistance and the Predicted Effect on Current First-line Regimens in Europe","volume":"62","author":"Hofstra","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"S57","DOI":"10.1093\/infdis\/jit111","article-title":"Transmission of drug resistant HIV and its potential impact on mortality and treatment outcomes in resource-limited settings","volume":"207","author":"Cambiano","year":"2013","journal-title":"J. Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1089\/aid.1998.14.669","article-title":"A sudden epidemic of HIV type 1 among injecting drug users in the former Soviet Union: Identification of subtype A, subtype B, and novel gagA\/envB recombinants","volume":"14","author":"Bobkov","year":"1998","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1016\/j.meegid.2016.10.018","article-title":"Primate immunodeficiency virus classification and nomenclature: Review","volume":"46","author":"Foley","year":"2016","journal-title":"Infect. Genet. Evol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1079","DOI":"10.1089\/aid.1998.14.1079","article-title":"Molecular epidemiology of an HIV-1 subtype A subcluster among injection drug users in the Southern Ukraine","volume":"14","author":"Novitsky","year":"1998","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Van de Klundert, M.A.A., Antonova, A., Di Teodoro, G., Ce\u00f1a Diez, R., Chkhartishvili, N., Heger, E., Kuznetsova, A., Lebedev, A., Narayanan, A., and Ozhmegova, E. (2022). Molecular Epidemiology of HIV-1 in Eastern Europe and Russia. Viruses, 14.","DOI":"10.3390\/v14102099"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1089\/aid.2017.0233","article-title":"Spatiotemporal Characteristics of the HIV-1 CRF02_AG\/CRF63_02A1 Epidemic in Russia and Central Asia","volume":"34","author":"Kostaki","year":"2018","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"592","DOI":"10.1089\/aid.2013.0196","article-title":"HIV-1 genetic diversity in Russia: CRF63_02A1, a new HIV type 1 genetic variant spreading in Siberia","volume":"30","author":"Baryshev","year":"2014","journal-title":"AIDS Res. Hum. Retrovir."},{"key":"ref_39","unstructured":"European Centre for Disease Prevention and Control (2019). Developing a Reporting System for the Surveillance of HIV Drug Resistance in Europe, ECDC. Available online: https:\/\/www.ecdc.europa.eu\/en\/publications-data\/developing-reporting-system-surveillance-hiv-drug-resistance-europe."},{"key":"ref_40","first-page":"127","article-title":"The prevalence of HIV recombinant forms in Russia and countries of the CIS: Systematic review and meta-analysis","volume":"8","author":"Pasechnik","year":"2018","journal-title":"Rus. J. Infect. Immun."},{"key":"ref_41","first-page":"14","article-title":"Rapid spread of the HIV-1 circular recombinant CRF02-AG in Russia and neighboring countries","volume":"60","author":"Moskaleychik","year":"2015","journal-title":"Vopr. Virusol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"5510","DOI":"10.1128\/JVI.02579-07","article-title":"Persistence of transmitted drug resistance among subjects with primary human immunodeficiency virus infection","volume":"82","author":"Little","year":"2008","journal-title":"J. Virol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"3100","DOI":"10.1128\/AAC.00348-13","article-title":"Effect of mutations at position E138 in HIV-1 reverse transcriptase and their interactions with the M184I mutation on defining patterns of resistance to nonnucleoside reverse transcriptase inhibitors rilpivirine and etravirine","volume":"57","author":"Xu","year":"2013","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"819","DOI":"10.3851\/IMP2771","article-title":"Prevalence in the USA of rilpivirine resistance-associated mutations in clinical samples and effects on phenotypic susceptibility to rilpivirine and etravirine","volume":"19","author":"Picchio","year":"2014","journal-title":"Antivir. Ther."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1080\/15284336.2015.1115585","article-title":"Clinical Outcomes of Virologically-Suppressed Patients with Pre-existing HIV-1 Drug Resistance Mutations Switching to Rilpivirine\/Emtricitabine\/Tenofovir Disoproxil Fumarate in the SPIRIT Study","volume":"17","author":"Porter","year":"2016","journal-title":"HIV Clin. Trials"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"e05373","DOI":"10.1002\/ccr3.5373","article-title":"Pre-existing singleton E138A mutations in the reverse transcriptase gene do not affect the efficacy of first-line antiretroviral therapy regimens using rilpivirine in human immunodeficiency virus-infected patients","volume":"10","author":"Kuznetsova","year":"2022","journal-title":"Clin. Case Rep."},{"key":"ref_47","unstructured":"World Health Organization (2017). Global Action Plan on HIV Drug Resistance 2017\u20132021, WHO. Available online: https:\/\/www.who.int\/publications\/i\/item\/978-92-4-151284-8."},{"key":"ref_48","unstructured":"World Health Organization (2017). Guidelines on the Public Health Response to Pretreatment HIV Drug Resistance, WHO. Available online: https:\/\/www.who.int\/publications\/i\/item\/9789241550055."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"846943","DOI":"10.3389\/fmicb.2022.846943","article-title":"Trends of Transmitted and Acquired Drug Resistance in Europe From 1981 to 2019: A Comparison Between the Populations of Late Presenters and Non-late Presenters","volume":"13","author":"Miranda","year":"2022","journal-title":"Front. Microbiol."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/15\/4\/991\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:17:50Z","timestamp":1760123870000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/15\/4\/991"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,18]]},"references-count":49,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["v15040991"],"URL":"https:\/\/doi.org\/10.3390\/v15040991","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4,18]]}}}