Flipped UVs have to be fixed by the game exporter and game engine. There is some easily-available code that helps solve this, on the NVIDIA developer site, called NVMeshMender.
Until this is implemented in the game engine, you will have shading seams. You’ll even have seams on non-mirrored UVs. For example, consider the UVs of a bipedal character, where the arm UVs are cut off at the shoulder, and the arm UVs are laid out vertically. Usually the chest UVs would also be vertical. But this causes a normal-mapping seam between the arm and chest, since the upper edge of the arm UV is horizontal, while the shoulder edge of the chest UV is vertical. This is without any mirroring. Because these two edges are at different angles, the normal map on either side of this seam will get different colors, signifying different directions for their normals, thus you’ll get a shading seam.
However, once your game engine uses the right kind of code to correct these differences, the seam should disappear (assuming there wasn’t a seam in the high-res model, and assuming you’re properly padding the edge texels).
The code basically duplicates vertices along the UV edges and massages their normals, which rotates the texel normals to match one another when the surfaces are rendered in-game.
(wow, I really need to update this thread)