Drug Resistance Mutations for Surveillance of Transmitted HIV-1 Drug-Resistance: 2009 Update

TLDR

Monitoring transmitted HIV‑1 drug resistance at local to global levels informs treatment guidelines and requires a consensus genotypic definition to enable accurate cross‑regional comparisons. The paper updates the list of surveillance drug‑resistance mutations (SDRMs) for transmitted HIV‑1 drug resistance studies. The authors applied the previously established criteria and procedures to compile an updated SDRM list. The updated SDRM list now contains 93 mutations—34 NRTI, 19 NNRTI, and 40 PI—expanding the original 80‑mutation set to reflect newly approved drugs and identified resistance mutations.

Abstract

Programs that monitor local, national, and regional levels of transmitted HIV-1 drug resistance inform treatment guidelines and provide feedback on the success of HIV-1 treatment and prevention programs. To accurately compare transmitted drug resistance rates across geographic regions and times, the World Health Organization has recommended the adoption of a consensus genotypic definition of transmitted HIV-1 drug resistance. In January 2007, we outlined criteria for developing a list of mutations for drug-resistance surveillance and compiled a list of 80 RT and protease mutations meeting these criteria (surveillance drug resistance mutations; SDRMs). Since January 2007, several new drugs have been approved and several new drug-resistance mutations have been identified. In this paper, we follow the same procedures described previously to develop an updated list of SDRMs that are likely to be useful for ongoing and future studies of transmitted drug resistance. The updated SDRM list has 93 mutations including 34 NRTI-resistance mutations at 15 RT positions, 19 NNRTI-resistance mutations at 10 RT positions, and 40 PI-resistance mutations at 18 protease positions.