Short Communication: Prevalence of Transmitted Resistance to Non-Nucleoside Reverse Transcriptase Inhibitors in European and North American Countries Over 20 Years: An Updated Meta-Analysis.

The prevalence of transmitted non-nucleoside reverse transcriptase inhibitor (NNRTI) resistance around the world has been estimated up to 2010. Treatment recommendations have since evolved from NNRTIs to integrase strand inhibitors (INSTIs). This analysis estimates more recent trends in transmitted NNRTI resistance given emerging INSTI use. Studies reporting prevalence of transmitted NNRTI resistance in Europe, the United States, and Canada were meta-analyzed to generate yearly estimates in four regions. Overall prevalence of transmitted resistance continued to rise in the United States to >10% in 2015. Prevalence in European countries with larger surveillance networks was consistent at ∼4% from 2000 through 2012, increasing to 7% in 2016. Prevalence in European countries with fewer available data was generally <5%. Two publications with Canadian data were identified, reporting 0%-3% resistance. This analysis showed increasing prevalence of transmitted NNRTI resistance up to 2016, despite the availability of newer classes of treatments.