IAS-USA update HIV drug resistance tables

Simon Collins, HIV i-Base

On 5 April 2023, the US International Antiviral Society IAS-USA publicised again their latest updated to the list of mutations associated with clinical resistance to HIV drugs and the accompanying user notes.

This edition covers the following drugs.

  • Cabotegravir, fostemsavir and ibalizumab are all now included. The capsid inhibitor lenacapavir (GS 6207) has been added to Figure 2.
  • A new section on recently approved drugs.
  • Several changes were made to the bars of the integrase strand transfer inhibitors (InSTIs) cabotegravir and dolutegravir, the protease inhibitors atazanavir and lopinavir, and the nonnucleoside analogue reverse transcriptase (NNRTI) inhibitor doravirine.
  • The user notes for tenofovir have been modified as recent clinical data suggest that the K65R plus M184V mutational profile is of less clinical relevance if tenofovir with either lamivudine or emtricitabine is prescribed in combination with a boosted protease inhibitor or one of the second generation InSTIs bictegravir or dolutegravir.
  • Antiretroviral drugs that are no longer recommended are listed at the bottom of the drug class and are shaded in gray. Their user notes are retained for historical significance.

These were published online in Topics in Antiviral Medicine.

The figures are also available as downloadable PDFs and are now available as PowerPoint Slides.

The mutations list is designed to help doctors make clinical decisions about the choice of ART.


Wensing AM et al. 2022 Update of the Drug Resistance Mutations in HIV-1. October 2022,

Links to other websites are current at date of posting but not maintained.