|"HIV-1 Drug ResistanceHIV-1 drug resistance associated mutations can be transmitted to persons who are antiretroviral-naive, called transmitted drug resistance (TDR). TDR has the potential to compromise first-line anti-retroviral therapy (ART) in HIV patients and limit the antiretroviral regimens options, which has become an important public health problem. TDR surveillance is an important strategy to monitor the emergence of enetic resistance. TDR usually emerges in regions where ART has been widely available for years. TDR has been reported in the United States for many years, significant resistance has been observed to the three main antiretroviral drug classes, nucleoside reverse transcriptase inhibitors (NRTIs), non-NRTIs (NNRTIs) and protease inhibitors (PIs). Since late 2007, several newer HIV medications, including Raltegravir, Maraviroc, Darunavir and Etravirine, were introduced, allowing for greater virologic suppression in patients on those treatment regimens. But studies have shown, that although the upward trend of the TDR rate from 2003-2007 has ceased due to the introduction of the new drugs, the TDR prevalence in 2008-2009 remained substantial, and was not significantly different than in prior years.
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