*4.2. Mutations*

PI-associated DRMs were defined as those with an HIVDB drug resistance program penalty score for ≥1 PI as of December 31, 2021 [51]. The DRMs included 57 mutations at 24 positions: L10F, K20T, L23I, L24I/F/M, D30N, V32I, L33F, K43T, M46I/L/V, I47A/V, G48A/L/M/Q/S/T/V, I50I/L, F53L, I54A/L/M/S/T/V, Q58E, G73A/C/D/S/T/V, T74P, L76V, V82A/C/F/L/M/S/T, N83D, I84A/C/V, N88D/G/S/T, L89V, and L90M. Major mutations were defined as those with a greater effect on the susceptibility to one or more PIs, an increased occurrence in patients with VF on PI-containing regimens, and a low likelihood of occurring without selective drug pressure. Additional PI-associated NP-TSMs that are not classified as DRMs were also examined [52]. The NP-TSMs included 56 mutations at 31 positions: L10R/Y, V11L, K20A, A22V, L33M, E34D/N/Q/R/V, M36A, L38W, K43I/N/P/Q/S, K45I/Q/V, G48E, G51A, F53I/W/Y, K55R/N, I66F/L/V, C67F/L, A71I/L, I72K/L, G73I/N, T74E, P79N, V82G, N83S, I85V, L89P/T, T91C/S, Q92R, C95F/L/V, and T96S.
