Prevalence of transmitted drug resistance mutations among patients infected with human immunodeficiency virus type 1 (HIV-1) in Henan Province, China

To the Editor: Even with the emergence of highly active antiretroviral therapy, human immunode fi ciency virus type 1 (HIV-1) remains a serious public health problem worldwide. The widespread use of antiretroviral therapy (ART) has, on the one hand, signi fi cantly improved life expectancy in patients infected with HIV-1; on the other hand, it has inevitably brought along with it a dif fi cult problem — viral resistance. Viral resistance is a common phenomenon evolutionarily, particularly in patients with poor adherence and suboptimal drug levels. Failed viral suppression due to viral resistance emerging in treatment-experienced patients can be avoided by adopting viral-susceptible ART regimens. However, viral resistance obtained during transmission, known as “ transmitted drug resistance, ” can be a major hurdle against the elimination of HIV-1 infection. As genotypic drug resistance testing in treatment-naive or newly diagnosed HIV-1 patients is not as widely implemented as in treatment-experienced patients. Transmitted drug resistance mutations (TDRMs) in HIV-1 pose a serious threat to the ef fi cacy of current ART regimens and pre-exposure prophylaxis (PrEP). A better understanding of the prevalence of local TDRMs can provide valuable data for clinical- and government-level decision-making. This study was approved