Fig. 1

Appearance of drug resistance mutations upon treatment failure in Uganda patients receiving first line cART. The Joint Clinical Research Centre treats over 15 000 HIV infected patients in Kampala, Uganda. As standard-of-care, patients are provided drug resistance testing upon evidence of treatment failure (plasma HIV-1 RNA load above 2000 copies/ml and/or CD4⁺ T-cell counts below 250 cells/ml). The drug resistance tests are performed with an in-house Sanger sequencing assay in a WHO-certified laboratory. Test results are stored in an anonymized database under IRB approval. Graph shows percentages of patients failing one of three first line cART regimens with any primary drug resistance mutations (DRMs), with an NNRTI resistant mutation (NNRTI R+), with a 3TC resistance mutation (3TC R+), and with thymidine analog resistance mutations (TAMs)