Two cases of possible transmitted HIV drug resistance to all currently available integrase inhibitors, the Netherlands, 2025.

Transmitted integrase inhibitor resistance in newly diagnosed HIV remains rare. We report two cases with baseline resistance to all currently available integrase inhibitors in the Netherlands in 2025. Clinical history and laboratory findings indicate possible transmitted resistance. The cases are not phylogenetically linked, representing two independent introductions of integrase inhibitor resistant HIV into the Dutch population. These observations highlight the need for strengthened surveillance and prevention efforts in Europe and globally.