{"doi":"10.1093/ofid/ofab587","title":"Statewide Longitudinal Trends in Transmitted HIV-1 Drug Resistance in Rhode Island, USA","abstract":"BACKGROUND: HIV-1 transmitted drug resistance (TDR) remains a global challenge that can impact care, yet its comprehensive assessment is limited and heterogenous. We longitudinally characterized statewide TDR in Rhode Island. METHODS: Demographic and clinical data from treatment-naïve individuals were linked to protease, reverse transcriptase, and integrase sequences routinely obtained over 2004-2020. TDR extent, trends, impact on first-line regimens, and association with transmission networks were assessed using the Stanford Database, Mann-Kendall statistic, and phylogenetic tools. RESULTS: In 1123 individuals, TDR to any antiretroviral increased from 8% (2004) to 26% (2020), driven by non-nucleotide reverse transcriptase inhibitor (NNRTI; 5%-18%) and, to a lesser extent, nucleotide reverse transcriptase inhibitor (NRTI; 2%-8%) TDR. Dual- and triple-class TDR rates were low, and major integrase strand transfer inhibitor resistance was absent. Predicted intermediate to high resistance was in 77% of those with TDR, with differential suppression patterns. Among all individuals, 34% were in molecular clusters, some only with members with TDR who shared mutations. Among clustered individuals, people with TDR were more likely in small clusters. CONCLUSIONS: In a unique (statewide) assessment over 2004-2020, TDR increased; this was primarily, but not solely, driven by NNRTIs, impacting antiretroviral regimens. Limited TDR to multiclass regimens and pre-exposure prophylaxis are encouraging; however, surveillance and its integration with molecular epidemiology should continue in order to potentially improve care and prevention interventions.","journal":"Open Forum Infectious Diseases","year":2021,"id":200683,"datarank":0.47057816804606784,"base_score":2.1972245773362196,"endowment":2.1972245773362196,"self_citation_contribution":0.32958368660043297,"citation_network_contribution":0.14099448144563487,"self_endowment_contribution":0.32958368660043297,"citer_contribution":0.14099448144563487,"corpus_percentile":59.58845826564555,"corpus_rank":5225,"citation_count":8,"citer_count":4,"citers_with_citation_signal":3,"citers_with_endowment":3,"datacite_reuse_total":0,"is_dataset":true,"is_dataset_confidence":0.7243,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2021-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":310905,"name":"Jon A. Steingrimsson","orcid":"0000-0003-2116-9377","position":1,"is_corresponding":false},{"id":778447,"name":"Fizza S. Gillani","orcid":"0000-0002-7156-153X","position":2,"is_corresponding":false},{"id":743705,"name":"Mark Howison","orcid":"0000-0002-0764-4090","position":3,"is_corresponding":false},{"id":107722,"name":"Su Aung","orcid":"0000-0002-8055-3136","position":4,"is_corresponding":false},{"id":778448,"name":"Matthew D. Solomon","orcid":"0000-0001-7846-9296","position":5,"is_corresponding":false},{"id":778449,"name":"Cindy Won","orcid":"0000-0001-6083-2050","position":6,"is_corresponding":false},{"id":778450,"name":"Amy L. Brotherton","orcid":"0000-0003-3975-6932","position":7,"is_corresponding":false},{"id":778451,"name":"Rajeev Shah","orcid":"0000-0003-0725-1809","position":8,"is_corresponding":false},{"id":561906,"name":"Casey W. Dunn","orcid":"0000-0003-0628-5150","position":9,"is_corresponding":false},{"id":778452,"name":"John P Fulton","orcid":"0000-0002-7114-8390","position":10,"is_corresponding":false},{"id":778453,"name":"Thomas Bertrand","orcid":"0000-0001-8693-8478","position":11,"is_corresponding":false},{"id":778454,"name":"Anna Civitarese","orcid":"0000-0003-0951-5222","position":12,"is_corresponding":false},{"id":778965,"name":"Katharine Howe","orcid":null,"position":13,"is_corresponding":false},{"id":440819,"name":"Theodore Marak","orcid":null,"position":14,"is_corresponding":false},{"id":390871,"name":"Philip A. Chan","orcid":"0000-0003-0964-5895","position":15,"is_corresponding":false},{"id":778966,"name":"Utpala Bandy","orcid":null,"position":16,"is_corresponding":false},{"id":778967,"name":"Nicole Alexander‐Scott","orcid":null,"position":17,"is_corresponding":false},{"id":379484,"name":"Joseph W. 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