Leveraging the Oxford Nanopore MinION sequencing platform for HIV-1 drug resistance surveillance in resource-limited settings: a post-COVID implementation opportunity

ONT MinION sequencing provides an accurate, rapid, and cost-effective alternative to Sanger sequencing for HIVDR genotyping in RLS. Its scalability, ability to detect minority variants, and compatibility with infrastructure setup up in response to the COVID-19 pandemic, make it a viable platform for both national HIVDR surveillance and decentralized clinical testing. Integrating ONT workflows into routine HIVDR monitoring could expand diagnostic access and enable more timely ART optimization in high-burden settings.