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A search of the PubMed, Cochrane, B-On, and Scopus databases up to December 2023 was conducted and included 11 studies with 1118 HIV-1 pol sequences. Drug resistance mutations (DRMs) to NNRTIs were found in 13% of the drug-naive individuals and 31% of those on ART, while NRTI resistance occurred in 5% and 10%, respectively. Dual-class resistance (NNRTI + NRTI) was detected in 2% of the drug-naive and 8% of ART-experienced individuals. DRMs to protease inhibitors (PIs) were found in 2% of the drug-naive and 5% of ART-experienced individuals. The rate of DRMs was significantly higher in Beira than in Maputo, as well as in pediatric patients than in adults and pregnant women. Subtype C predominated (94%) and was associated with lower viral loads and DRM rates as compared to the other subtypes. The high prevalence of DRMs, particularly to NNRTIs and NRTIs, highlights the need for ongoing surveillance and targeted interventions. These findings are critical for optimizing ART regimens and informing public health strategies in Mozambique, with particular attention to regions such as Beira and vulnerable populations such as pediatric patients.<\/jats:p>","DOI":"10.3390\/v16121808","type":"journal-article","created":{"date-parts":[[2024,11,21]],"date-time":"2024-11-21T04:46:11Z","timestamp":1732164371000},"page":"1808","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["HIV-1 Antiretroviral Drug Resistance in Mozambique: A Systematic Review and Meta-Analysis"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1009-6715","authenticated-orcid":false,"given":"Paloma","family":"Gon\u00e7alves","sequence":"first","affiliation":[{"name":"Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6584-1199","authenticated-orcid":false,"given":"Paulo","family":"Mascarenhas","sequence":"additional","affiliation":[{"name":"Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Quinta da Granja, 2829-511 Caparica, Portugal"}]},{"given":"Rute","family":"Marcelino","sequence":"additional","affiliation":[{"name":"Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003 Lisbon, Portugal"},{"name":"Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Quinta da Granja, 2829-511 Caparica, Portugal"}]},{"given":"N\u00e9dio","family":"Mabunda","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Sa\u00fade de Mozambique (INS), Estrada Nacional N1, Maputo 1102, Mozambique"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3569-9176","authenticated-orcid":false,"given":"Arne","family":"Kroidl","sequence":"additional","affiliation":[{"name":"Division of Infectious Disease and Tropical Medicine, University of Munich (LMU), Leopoldstra\u00dfe 5, 80802 Munich, Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6304-2262","authenticated-orcid":false,"given":"W. Chris","family":"Buck","sequence":"additional","affiliation":[{"name":"David Geffen School of Medicine, University of California Los Angeles, 10833 Le Conte Ave, Los Angeles, CA 90095, USA"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6880-6655","authenticated-orcid":false,"given":"Ilesh","family":"Jani","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Sa\u00fade de Mozambique (INS), Estrada Nacional N1, Maputo 1102, Mozambique"}]},{"given":"Claudia","family":"Palladino","sequence":"additional","affiliation":[{"name":"Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0176-5585","authenticated-orcid":false,"given":"Nuno","family":"Taveira","sequence":"additional","affiliation":[{"name":"Research Institute for Medicines (iMed.ULisboa), Faculty of Pharmacy, Universidade de Lisboa, Avenida Professor Gama Pinto, 1649-003 Lisbon, Portugal"},{"name":"Egas Moniz Center for Interdisciplinary Research (CiiEM), Egas Moniz School of Health & Science, Quinta da Granja, 2829-511 Caparica, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2024,11,21]]},"reference":[{"key":"ref_1","unstructured":"UNAIDS (2021). 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