Abstract
<title>Abstract</title> <p>Background Transmitted drug resistance (TDR) among newly diagnosed people living with HIV-1 (PLWH) has seen an upward trend globally, and its detection before the initiation of antiretroviral therapy (ART) is vital for treatment efficacy. Methods Newly diagnosed PLWH receiving routine genotypic drug resistance testing from January 2025 to December 2025 in Henan Province were included for TDR analysis. The partial pol and the complete integrase gene coding sequences were separately amplified, sequenced, and analyzed. Results Of a total of 1,286 patients, partial pol sequences and integrase sequences were obtained from 1,253 patients. Among these, CRF07_BC (46.61%, 584/1,253) was the dominant subtype, followed by CRF01_AE (25.54%, 320/1,253), B (17.40%, 218/1,253), CRF55_01B (4.87%, 61/1,253), and CRF08_BC (2.23%, 28/1,253). TDR was detected in 175 patients (13.97%), and the prevalence of low-level or above drug resistance against nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs), and integrase strand transfer inhibitors (INSTIs) was 1.44% (18/1,253), 8.94% (112/1,253), 3.83% (48/1,253), and 0.40% (5/1,253), respectively. The prevalence of TDR for CRF55_01B increased by approximately 10% compared with the previous year, and transmission network analysis showed no evidence of cluster-based transmissions. Conclusions The overall transmitted TDR rate is showing an upward trend compared to previous years, with certain subtypes increasing rapidly, warranting special attention.</p>