A recent study of the French ANRS AC11 virology network assessed the virological outcome of 39 INI-naïve patients with E157Q-mutated virus initiating an INI-based regimen . Among them, 15 had a viral load (VL) < 50 c/mL at initiation and virological suppression was maintained during the first-year follow-up in all but two exhibiting a viral blip. Twenty-four patients had a VL > 50 c/mL at time of INI-based regimen initiation. Among them eight were receiving their first-line c ART and the two patients who did not reach VL < 50 c/mL at W24 were receiving EVG-based single-tablet regimen. The 16 remaining patients were cART-experienced in VF with drug-resistant viruses and they displayed several virological outcomes to the INI-based regimen, independently of the genotypic susceptibility score of the cART. Thus, taking into account all the data, in case of E157Q polymorphism, the most recommended INI might be DTG in such patients; EVG should not be considered due to potential low-level resistance, especially in the context of CRF02_AG recombinant and RAL seems adequate with unmounted IC50 but with the caveat that selection of E157Q has been described at VF in two case reports.