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Background Surveillance data indicate a decline in the prevalence of antiretroviral drug resistance among treated patients. Improved treatment strategies.

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Share your thoughts on this presentation with #IAS2019 Evolution on HIV drug resistance surveillance in Brazil: a declining trend to celebrate Rosana Elisa Gonçalves Gonçalves Pinho, Nazle Mendonça Collaço Véras, Ana Roberta Pascom, José Boullosa, Fernanda Rick, Gerson Fernando Mendes Pereira Department of Diseases of Chronic Condition and Sexually Transmitted Infections, Secretariat for Health Surveillance, Ministry of Health of Brazil Share your thoughts on this presentation with #IAS2019

I have no conflicts of interest to disclosure.

Brazil’s Genotyping test offering Pretreatment HIV genotyping test: pregnant woman, children, serodifferent couples, HIV/TB co-infected, seroconversion on PrEP and individuals initiating antiretroviral therapy with EFV. All individuals under ART experiencing virological failure Information System for Genotyping Network (Sisgeno)

52,658 PR-RT sequences from 44,806 individuals from 2008-2018 Methods/Results 52,658 PR-RT sequences from 44,806 individuals from 2008-2018 18+ ARV-experienced individuals Stanford HIVdb Program (High‐Level DRMs - Score = 60+) HIV subtype (Rega HIV Subtyping) Demographic and clinical characteristcs

HIV drug resistance amongst people taking ART decreased over the last decade

DR Mutations K103 – 27% (NNRTI) M184 – 27% (NRTI) M46 – 11% (PI) I54 – 9% (PI) K65 – 8% (NRTI)

HIV resistance according to the number of drugs exposed before genotyping test

HIV resistance according to the number of drugs exposed before genotyping test

Distribution of HIV-1 Subtypes in Brazil North Northeast Distribution of HIV-1 Subtypes in Brazil Center-West Southeast South

Resistance to ARV class according to the most frequent subtypes in Brazil

Conclusions Acquired HIV drug resistance decreased over the decade in Brazil. Continuous improvement of the monitoring of HIV drug resistance routine is particularly important to minimize the spread of resistance in country, specially related to new drugs, and thus to contribute to the control of the HIV epidemic.

Thank you!