摘要Objective This study aimed to investigate the prevalence of HIV pretreatment drug resistance(PDR)and the transmission clusters associated with PDR-related mutations in newly diagnosed,treatment-naive patients between 2020 and 2023 in Dehong prefecture,Yunnan province,China.Methods Demographic information and plasma samples were collected from study participants.PDR was assessed using the Stanford HIV Drug Resistance Database.The Tamura-Nei 93 model within HIV-TRACE was employed to compute pairwise matches with a genetic distance of 0.015 substitutions per site.Results Among 948 treatment-naive individuals with eligible sequences,36 HIV subtypes were identified,with unique recombinant forms(URFs)being the most prevalent(18.8%,178/948).The overall prevalence of PDR was 12.4%(118/948),and resistance to non-nucleotide reverse transcriptase inhibitors(NNRTIs),nucleotide reverse transcriptase inhibitors(NRTIs),and protease inhibitors(PIs)was 10.7%,1.3%,and 1.6%,respectively.A total of 91 clusters were identified,among which eight showed evidence of PDR strain transmission.The largest PDR-associated cluster consisted of six CRF01_AE drug-resistant strains carrying K103N and V179T mutations;five of these individuals had initial CD4+cell counts<200 cells/μL.Conclusion The distribution of HIV subtypes in Dehong is diverse and complex.PDR was moderately prevalent(12.4%)between 2020 and 2023.Evidence of transmission of CRF01_AE strains carrying K103N and V179T mutations was found.Routine surveillance of PDR and the strengthening of control measures are essential to limit the spread of drug-resistance HIV strains.