the frequency of hiv-1 infection and surveillance drug-resistant mutations determination among iranians with high-risk behaviors, during 2014 to 2020

background and objectives: human immunodeficiency virus (hiv) has various transmission routes. instant antiretroviral therapy (art) is the recommended treatment for hiv infection. highly active antiretroviral therapy (haart) significantly decreases the acquired immunodeficiency syndrome (aids) and aids-related co-morbidities. notwithstanding the suit- ability of haart, the antiretrovirals (arvs) have adverse effects and antiretroviral drug resistance mutations are reported among those who receive arvs. in this survey, the abundance of hiv-1 infection in iranians with high-risk behaviors, and detection of the surveillance drug-resistant mutations (sdrms) were evaluated. materials and methods: this cross-sectional study was conducted on 250 individuals with high-risk behaviors from sep- tember 2014 to february 2020. hiv-1 ag/ab in plasma samples was detected using enzyme immunoassay (eia) kits. the conserved region of hiv-1 was detected in the plasma samples by real-time polymerase chain reaction (pcr) assay. further- more, in individuals with positive hiv-1 rna, hiv-1 viral load testing was performed. after amplification and sequencing of the hiv-1 protease, reverse transcriptase, and integrase genes, surveillance drug resistance mutation (sdrm) and phylo-genetic analysis were determined. results: out of the 250 participants with high-risk behaviors, six (2.4%) were infected with hiv-1. according to the phylogenetic analysis, the crf35_ad (83.3% or 5/6) was the dominant subtype, followed by crf01_ae (16.7% or 1/6). in this research, in none of the hiv-1 infected patients, sdrm for protease inhibitors (pis), nucleoside reverse transcriptase inhibitors (nrtis), non-nucleoside reverse transcriptase inhibitors (nnrtis), and integrase inhibitors (ins) were observed. nevertheless, in one of the patients, v179l mutation was detected which is a rare non-polymorphic mutation and is listed as a rilpivirine (rpv) -associated resistance mutation. conclusion: the results of the current survey revealed that 2.4% of people with high-risk behaviors are infected with hiv and the level of drug resistance mutations (drms) in these people is very low.