{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:53:21Z","timestamp":1792806801848,"version":"4.5.0"},"reference-count":49,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T00:00:00Z","timestamp":1718323200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"State Key Laboratory of Infections Disease Prevention and Control, the Ministry of Science and Technology of China","award":["2019SKLID602"],"award-info":[{"award-number":["2019SKLID602"]}],"id":[{"id":"https:\/\/ror.org\/04bhsv505","id-type":"ROR","asserted-by":"crossref"}]},{"name":"State Key Laboratory of Infections Disease Prevention and Control, the Ministry of Science and Technology of China","award":["2021SKLID303"],"award-info":[{"award-number":["2021SKLID303"]}],"id":[{"id":"https:\/\/ror.org\/04bhsv505","id-type":"ROR","asserted-by":"crossref"}]},{"name":"State Key Laboratory of Infections Disease Prevention and Control, the Ministry of Science and Technology of China","award":["2012ZX10004910"],"award-info":[{"award-number":["2012ZX10004910"]}],"id":[{"id":"https:\/\/ror.org\/04bhsv505","id-type":"ROR","asserted-by":"crossref"}]},{"name":"State Key Laboratory of Infections Disease Prevention and Control, the Ministry of Science and Technology of China","award":["2022YFC2305201"],"award-info":[{"award-number":["2022YFC2305201"]}],"id":[{"id":"https:\/\/ror.org\/04bhsv505","id-type":"ROR","asserted-by":"crossref"}]},{"name":"State Key Laboratory of Infections Disease Prevention and Control, the Ministry of Science and Technology of China","award":["81861138011"],"award-info":[{"award-number":["81861138011"]}],"id":[{"id":"https:\/\/ror.org\/04bhsv505","id-type":"ROR","asserted-by":"crossref"}]},{"name":"the National Natural Science Foundation International\/Inter-Organization Cooperation and Exchange Study-NSFC-VR Project (China and Switzerland)","award":["2019SKLID602"],"award-info":[{"award-number":["2019SKLID602"]}]},{"name":"the National Natural Science Foundation International\/Inter-Organization Cooperation and Exchange Study-NSFC-VR Project (China and Switzerland)","award":["2021SKLID303"],"award-info":[{"award-number":["2021SKLID303"]}]},{"name":"the National Natural Science Foundation International\/Inter-Organization Cooperation and Exchange Study-NSFC-VR Project (China and Switzerland)","award":["2012ZX10004910"],"award-info":[{"award-number":["2012ZX10004910"]}]},{"name":"the National Natural Science Foundation International\/Inter-Organization Cooperation and Exchange Study-NSFC-VR Project (China and Switzerland)","award":["2022YFC2305201"],"award-info":[{"award-number":["2022YFC2305201"]}]},{"name":"the National Natural Science Foundation International\/Inter-Organization Cooperation and Exchange Study-NSFC-VR Project (China and Switzerland)","award":["81861138011"],"award-info":[{"award-number":["81861138011"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Viruses"],"abstract":"<jats:p>The human immunodeficiency virus type-1 epidemic in Pakistan has significantly increased over the last two decades. In Karachi, Pakistan, there is a lack of updated information on the complexity of HIV-1 genetic diversity and the burden of drug resistance mutations (DRMs) that can contribute to ART failure and poor treatment outcomes. This study aimed to determine HIV-1 genetic diversity and identify drug-resistance mutations among people living with HIV in Karachi. A total of 364 HIV-positive individuals, with a median age of 36 years, were enrolled in the study. The HIV-1 partial pol gene was successfully sequenced from 268 individuals. The sequences were used to generate phylogenetic trees to determine clade diversity and also to assess the burden of DRMs. Based on the partial pol sequences, 13 distinct HIV-1 subtypes and recombinant forms were identified. Subtype A1 was the most common clade (40%), followed by CRF02_AG (33.2%). Acquired DRMs were found in 30.6% of the ART-experienced patients, of whom 70.7%, 20.7%, and 8.5% were associated with resistance to NNRTIs, NRTIs, and PIs, respectively. Transmitted DRMs were found in 5.6% of the ART-na\u00efve patients, of whom 93% were associated with resistance against NNRTIs and 7% to PIs. The high prevalence of DRMs in ART-experienced patients poses significant challenges to the long-term benefits and sustainability of the ART program. This study emphasizes the importance of continuous HIV molecular epidemiology and drug resistance surveillance to support evidence-based HIV prevention, precise ART, and targeted AIDS care.<\/jats:p>","DOI":"10.3390\/v16060962","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T10:42:34Z","timestamp":1718361754000},"page":"962","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Human Immunodeficiency Virus Type-1 Genetic Diversity and Drugs Resistance Mutations among People Living with HIV in Karachi, Pakistan"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4539-5320","authenticated-orcid":false,"given":"Abdur","family":"Rashid","sequence":"first","affiliation":[{"name":"School of Medicine, Nankai University, Tianjin 300071, China"},{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing 102206, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Kang","sequence":"additional","affiliation":[{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing 102206, China"},{"name":"College of Life Sciences, Nankai University, Tianjin 300071, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Yi","sequence":"additional","affiliation":[{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing 102206, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qingfei","family":"Chu","sequence":"additional","affiliation":[{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing 102206, China"},{"name":"State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharaf Ali","family":"Shah","sequence":"additional","affiliation":[{"name":"Bridge Consultants Foundation, Karachi 75100, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3390-7659","authenticated-orcid":false,"given":"Syed Faisal","family":"Mahmood","sequence":"additional","affiliation":[{"name":"Department of Medicine, Aga Khan University, Karachi 74800, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8222-0132","authenticated-orcid":false,"given":"Yimam","family":"Getaneh","sequence":"additional","affiliation":[{"name":"State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China"},{"name":"Ethiopian Public Health Institute, Addis Ababa P.O. Box 1242, Ethiopia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Wei","sequence":"additional","affiliation":[{"name":"School of Medicine, Nankai University, Tianjin 300071, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Song","family":"Chang","sequence":"additional","affiliation":[{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing 102206, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9497-0902","authenticated-orcid":false,"given":"Syed Hani","family":"Abidi","sequence":"additional","affiliation":[{"name":"Department of Biological and Biomedical Sciences, Aga Khan University, Karachi 74800, Pakistan"},{"name":"Department of Biomedical Sciences, School of Medicine, Nazarbayev University, Astana 010000, Kazakhstan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9416-190X","authenticated-orcid":false,"given":"Yiming","family":"Shao","sequence":"additional","affiliation":[{"name":"School of Medicine, Nankai University, Tianjin 300071, China"},{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing 102206, China"},{"name":"College of Life Sciences, Nankai University, Tianjin 300071, China"},{"name":"State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China"},{"name":"Changping Laboratory, Yard 28, Science Park Road, Changping District, Beijing 102206, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,14]]},"reference":[{"key":"ref_1","unstructured":"(2024, June 06). The Path that Ends AIDS: 2023 UNAIDS Global AIDS Update. Available online: https:\/\/www.aidsdatahub.org\/resource\/path-ends-aids-2023-unaids-global-aids-update."},{"key":"ref_2","unstructured":"(2017). Guidelines on the Public Health Response to Pretreatment HIV Drug Resistance."},{"key":"ref_3","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_4","doi-asserted-by":"crossref","first-page":"12734","DOI":"10.1038\/s41598-021-92210-2","article-title":"Transmitted HIV drug resistance and subtype patterns among blood donors in Poland","volume":"11","author":"Parczewski","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Zhao, B., Song, W., Kang, M., Dong, X., Li, X., Wang, L., Liu, J., Ding, H., Chu, Z., and Wang, L. (2021). Molecular Network Analysis Reveals Transmission of HIV-1 Drug-Resistant Strains among Newly Diagnosed HIV-1 Infections in a Moderately HIV Endemic City in China. Front. Microbiol., 12.","DOI":"10.3389\/fmicb.2021.797771"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3137","DOI":"10.1093\/jac\/dky278","article-title":"Pretreatment HIV drug resistance among adults initiating ART in Namibia","volume":"73","author":"Taffa","year":"2018","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"de Bernardi Schneider, A., Cholette, F., Pelcat, Y., Lim, A., Vickerman, P., Hassan, A., Thompson, L., Blanchard, J., Emmanuel, F., and Reza, T. (2021). HIV Phylogenetics Reveals Overlapping Transmission Networks among Cities and Key Populations in Pakistan. medRxiv.","DOI":"10.1101\/2021.12.14.21267743"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Cholette, F., Joy, J., Pelcat, Y., Thompson, L.H., Pilon, R., Ho, J., Capina, R., Archibald, C., Blanchard, J.F., and Emmanuel, F. (2020). HIV-1 phylodynamic analysis among people who inject drugs in Pakistan correlates with trends in illicit opioid trade. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0237560"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.ijid.2018.04.3982","article-title":"Viral Suppression and Loss to Follow Up in HIV\/AIDS Patients on Antiretroviral Therapy in Pakistan","volume":"73","author":"Assir","year":"2018","journal-title":"Int. J. Infect. Dis."},{"key":"ref_10","unstructured":"(2024, June 06). Country Progress Report-Pakistan. Global AIDS Monitoring 2020. Available online: https:\/\/www.unaids.org\/sites\/default\/files\/country\/documents\/PAK_2020_countryreport.pdf."},{"key":"ref_11","unstructured":"(2024, March 01). Integrated Biological and Behavioral Surveillance in Pakistan: Round 5\u20142016-17. Available online: https:\/\/www.aidsdatahub.org\/resource\/ibbs-pakistan-round-5-2016-2017."},{"key":"ref_12","unstructured":"NACP (2024, June 05). HIV Treatment Services 2019, Available online: https:\/\/www.nacp.gov.pk\/whatwedo\/treatment.html."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Siddiqui, D., Badar, U., Javaid, M., Farooqui, N., Shah, S.A., Iftikhar, A., Sultan, F., Mir, F., Furqan, S., and Mahmood, S.F. (2023). Genetic and antiretroviral drug resistance mutations analysis of reverse transcriptase and protease gene from Pakistani people living with HIV-1. PLoS ONE, 18.","DOI":"10.1371\/journal.pone.0290425"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1089\/aid.2010.0324","article-title":"Antiretroviral drug resistance mutations among treated and treatment-naive patients in Pakistan: Diversity of the HIV type 1 pol gene in Pakistan","volume":"27","author":"Shah","year":"2011","journal-title":"AIDS Res. Hum. Retroviruses"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1089\/aid.1988.4.149","article-title":"Human immunodeficiency virus-associated disorders in Pakistan","volume":"4","author":"Khanani","year":"1988","journal-title":"AIDS Res. Hum. Retroviruses"},{"key":"ref_16","unstructured":"(2024, March 02). Karachi\u2019s District Central Has Highest Number of HIV Patients in Sindh. Available online: https:\/\/www.geo.tv\/latest\/366773-karachis-district-central-has-highest-number-of-hive-patients-in-sindh."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.tim.2012.12.005","article-title":"HIV among women and children in Pakistan","volume":"21","author":"Raees","year":"2013","journal-title":"Trends Microbiol."},{"key":"ref_18","first-page":"292","article-title":"HIV-1 drug resistance and resistance testing","volume":"46","author":"Clutter","year":"2016","journal-title":"Infect. Genet. Evol. J. Mol. Epidemiol. Evol. Genet. Infect. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1016\/j.jgar.2022.07.019","article-title":"Evaluation of HIV-1 drug resistance among patients failing first-line antiretroviral therapy in Ethiopia","volume":"30","author":"Getaneh","year":"2022","journal-title":"J. Glob. Antimicrob. Resist."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Zhou, Z., Wagar, N., DeVos, J.R., Rottinghaus, E., Diallo, K., Nguyen, D.B., Bassey, O., Ugbena, R., Wadonda-Kabondo, N., and McConnell, M.S. (2011). Optimization of a low cost and broadly sensitive genotyping assay for HIV-1 drug resistance surveillance and monitoring in resource-limited settings. PLoS ONE, 6.","DOI":"10.1371\/journal.pone.0028184"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1160","DOI":"10.1093\/bib\/bbx108","article-title":"MAFFT online service: Multiple sequence alignment, interactive sequence choice and visualization","volume":"20","author":"Katoh","year":"2019","journal-title":"Brief. Bioinform."},{"key":"ref_22","first-page":"380","article-title":"Comparative performance of the REGA subtyping tool version 2 versus version 1","volume":"10","author":"Abecasis","year":"2010","journal-title":"Infect. Genet. Evol. J. Mol. Epidemiol. Evol. Genet. Infect. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e144","DOI":"10.1093\/nar\/gku739","article-title":"COMET: Adaptive context-based modeling for ultrafast HIV-1 subtype identification","volume":"42","author":"Struck","year":"2014","journal-title":"Nucleic Acids Res."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1093\/molbev\/msu300","article-title":"IQ-TREE: A fast and effective stochastic algorithm for estimating maximum-likelihood phylogenies","volume":"32","author":"Nguyen","year":"2015","journal-title":"Mol. Biol. Evol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Ragonnet-Cronin, M., Hodcroft, E., Hu\u00e9, S., Fearnhill, E., Delpech, V., Brown, A.J., and Lycett, S. (2013). Automated analysis of phylogenetic clusters. BMC Bioinform., 14.","DOI":"10.1186\/1471-2105-14-317"},{"key":"ref_26","first-page":"111","article-title":"2019 update of the drug resistance mutations in HIV-1","volume":"27","author":"Wensing","year":"2019","journal-title":"Top. Antivir. Med."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1089\/aid.1998.14.453","article-title":"Failure to quantify viral load with two of the three commercial methods in a pregnant woman harboring an HIV type 1 subtype G strain","volume":"14","author":"Debyser","year":"1998","journal-title":"AIDS Res. Hum. Retroviruses"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e620","DOI":"10.1016\/S2352-3018(20)30172-7","article-title":"Virological failure, HIV-1 drug resistance, and early mortality in adults admitted to hospital in Malawi: An observational cohort study","volume":"7","author":"Fielding","year":"2020","journal-title":"Lancet HIV"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Abidi, S.H., Nduva, G.M., Siddiqui, D., Rafaqat, W., Mahmood, S.F., Siddiqui, A.R., Nathwani, A.A., Hotwani, A., Shah, S.A., and Memon, S. (2021). Phylogenetic and Drug-Resistance Analysis of HIV-1 Sequences from an Extensive Paediatric HIV-1 Outbreak in Larkana, Pakistan. Front. Microbiol., 12.","DOI":"10.3389\/fmicb.2021.658186"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"17195","DOI":"10.1038\/s41598-022-22163-7","article-title":"Antiretroviral therapy resistance mutations among HIV infected people in Kazakhstan","volume":"12","author":"Mukhatayeva","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"W13","DOI":"10.1097\/01.aids.0000247564.73009.bc","article-title":"Global and regional distribution of HIV-1 genetic subtypes and recombinants in 2004","volume":"20","author":"Hemelaar","year":"2006","journal-title":"AIDS"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Chen, Y., Hora, B., DeMarco, T., Shah, S.A., Ahmed, M., Sanchez, A.M., Su, C., Carter, M., Stone, M., and Hasan, R. (2016). Fast Dissemination of New HIV-1 CRF02\/A1 Recombinants in Pakistan. PLoS ONE, 11.","DOI":"10.1371\/journal.pone.0167839"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"967","DOI":"10.1007\/s00705-020-04551-4","article-title":"The emergence of an unassigned complex recombinant form in a Pakistani HIV-infected individual","volume":"165","author":"Tariq","year":"2020","journal-title":"Arch. Virol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e772","DOI":"10.1016\/S2352-3018(20)30252-6","article-title":"Global and regional epidemiology of HIV-1 recombinants in 1990\u20132015: A systematic review and global survey","volume":"7","author":"Hemelaar","year":"2020","journal-title":"Lancet HIV"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1016\/j.antiviral.2014.04.001","article-title":"E138A in HIV-1 reverse transcriptase is more common in subtype C than B: Implications for rilpivirine use in resource-limited settings","volume":"107","author":"Jordan","year":"2014","journal-title":"Antivir. Res."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Ismael, N., Wilkinson, E., Mahumane, I., Gemusse, H., Giandhari, J., Bauhofer, A., Vubil, A., Mambo, P., Singh, L., and Mabunda, N. (2022). Molecular Epidemiology and Trends in HIV-1 Transmitted Drug Resistance in Mozambique 1999\u20132018. Viruses, 14.","DOI":"10.3390\/v14091992"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e102","DOI":"10.1017\/S095026882000093X","article-title":"The characteristics of pretreatment HIV-1 drug resistance in western Yunnan, China","volume":"148","author":"Chen","year":"2020","journal-title":"Epidemiol. Infect."},{"key":"ref_38","first-page":"183","article-title":"Prevalence of drug resistance among HIV-1 treatment-naive patients in Greece during 2003-2015: Transmitted drug resistance is due to onward transmissions","volume":"54","author":"Paraskevis","year":"2017","journal-title":"Infect. Genet. Evol. J. Mol. Epidemiol. Evol. Genet. Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"607.e1","DOI":"10.1016\/j.cmi.2015.02.011","article-title":"Predicted residual activity of rilpivirine in HIV-1 infected patients failing therapy including NNRTIs efavirenz or nevirapine","volume":"21","author":"Theys","year":"2015","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1007\/s00705-017-3564-1","article-title":"HIV-1 genetic diversity, geographical linkages and antiretroviral drug resistance among individuals from Pakistan","volume":"163","author":"Khan","year":"2018","journal-title":"Arch. Virol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1093\/infdis\/jiaa683","article-title":"Clinical Impact of Pretreatment Human Immunodeficiency Virus Drug Resistance in People Initiating Nonnucleoside Reverse Transcriptase Inhibitor-Containing Antiretroviral Therapy: A Systematic Review and Meta-analysis","volume":"224","author":"Bertagnolio","year":"2021","journal-title":"J. Infect. Dis."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"4999","DOI":"10.1128\/JVI.75.11.4999-5008.2001","article-title":"Genotypic correlates of phenotypic resistance to efavirenz in virus isolates from patients failing nonnucleoside reverse transcriptase inhibitor therapy","volume":"75","author":"Bacheler","year":"2001","journal-title":"J. Virol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1089\/aid.2006.22.289","article-title":"Phenotypic drug resistance patterns in subtype A HIV-1 clones with nonnucleoside reverse transcriptase resistance mutations","volume":"22","author":"Eshleman","year":"2006","journal-title":"AIDS Res. Hum. Retroviruses"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"ofac481","DOI":"10.1093\/ofid\/ofac481","article-title":"Antiretroviral Drug Resistance in HIV Sequences From People Who Inject Drugs and Men Who Have Sex With Men Across 21 Cities in India","volume":"9","author":"Clipman","year":"2022","journal-title":"Open Forum Infect. Dis."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/s12985-020-01311-3","article-title":"Prevalence of acquired drug resistance mutations in antiretroviral- experiencing subjects from 2012 to 2017 in Hunan Province of central South China","volume":"17","author":"Zou","year":"2020","journal-title":"Virol. J."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1773","DOI":"10.2217\/fmb.15.106","article-title":"Resistance to reverse transcriptase inhibitors used in the treatment and prevention of HIV-1 infection","volume":"10","author":"Wainberg","year":"2015","journal-title":"Future Microbiol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"S51","DOI":"10.1086\/505356","article-title":"Rationale and uses of a public HIV drug-resistance database","volume":"194","author":"Shafer","year":"2006","journal-title":"J. Infect. Dis."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1054","DOI":"10.1093\/jac\/dkx508","article-title":"Impact of antiretroviral resistance and virological failure on HIV-1 informational entropy","volume":"73","author":"Lima","year":"2018","journal-title":"J. Antimicrob. Chemother."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"3722","DOI":"10.1128\/JVI.78.7.3722-3732.2004","article-title":"Positive selection detection in 40,000 human immunodeficiency virus (HIV) type 1 sequences automatically identifies drug resistance and positive fitness mutations in HIV protease and reverse transcriptase","volume":"78","author":"Chen","year":"2004","journal-title":"J. Virol."}],"container-title":["Viruses"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1999-4915\/16\/6\/962\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:59:03Z","timestamp":1760108343000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1999-4915\/16\/6\/962"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,14]]},"references-count":49,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2024,6]]}},"alternative-id":["v16060962"],"URL":"https:\/\/doi.org\/10.3390\/v16060962","relation":{},"ISSN":["1999-4915"],"issn-type":[{"value":"1999-4915","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,14]]}}}