There is a high prevalence of transmitted drug resistance (TDR) among HIV-infected individuals in metropolitan Washington, D.C., regardless of gender, and active surveillance is needed to guide appropriate antiretroviral usage. This according to a study of HIV genotype data of 710 individuals in metropolitan Washington, D.C., enrolled from 1994 to 2013 (median age 38.6 years). Researchers found:

• TDR was 22.5% among 566 treatment naïve individuals; 15.8% had nucleoside reverse transcriptase inhibitor (NRTI) resistance, 9.8% had non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance, and 4.2% had protease inhibitor (PI) resistance.

• Single class TDR was 10.0%, 5.1%, 1.6% to NRTIs, NNRTIs, and PIs, respectively.

• Dual TDR to PI and NRTI was observed in 1.6%, NRTI, and NNRTI in 3.4%, and triple class TDR in 0.9%.

• The most common NRTI-associated TDR mutations were L215Y/F/D/S (7.0%), D67N/G/E (5.0%), M41L (4.6%), K70R (4.5%), and M184V (3.9%); NNRTI-associated mutation was K103N/S (7.1%); and PI-associated mutation was L90M (2.0%).

• TDR frequency decreased from 1994 to 2006 (27.1%) to 2007 to 2013 (19.4%).

Citation: Kassaye SG, Grossman Z, Balamane M, et al. Transmitted HIV drug resistance high and longstanding in metropolitan Washington, D.C. [Published online ahead of print June 15, 2016]. Clin Infect Dis. doi:10.1093/cid/ciw382.