Successful prevention of transmission of integrase resistance in the Swiss HIV Cohort Study.

Prevalence of integrase inhibitor (INSTI) transmitted drug resistance (TDR) may increase with the increasing use of INSTIs. We analysed the prevalence of INSTI TDR in the Swiss HIV Cohort Study (2008-2014). In 1 of 1,316 (0.1%) drug-naïve samples a major INSTI TDR mutation was detected. Prevalence was stable although INSTIs were increasingly used. We showed that this is in contrast to the introduction of previous drug classes where more treatment failures with resistant strains occurred and TDR was observed more rapidly. We demonstrated on a population-level that it is possible to avoid TDR affecting a new drug class for years.