HIV drug resistance now high enough to trigger a change in first-line treatment in eastern and southern Africa
Aidsmap - "HIV drug resistance is increasing rapidly in southern and eastern Africa and Latin America and, as a result, it may soon be necessary to change the recommended first-line antiretroviral drug regimen in many countries to integrase inhibitor-based treatment, according to an analysis published in The Lancet Infectious Diseases on 30 November.
In the period 2014-2016, around one person in eight starting treatment in Latin America (12.4%), southern Africa (12.2%) and eastern Africa (11.8%) already had resistance to at least one antiretroviral drug, predominantly to drugs of the non-nucleoside reverse transcriptase inhibitor (NNRTI) class.[...]
As well as reconsidering treatment guidelines, the authors recommend that routine surveillance of population-level drug resistance should be stepped up and that treatment programmes should monitor robust indicators of a heightened risk of drug resistance, such as retention in care, on-time pill pick-up and drug stock-outs. When the prevalence of drug resistance in previously untreated people reaches 10% governments must be prepared to act rapidly, for example by considering a switch to new fixed-dose products containing the integrase inhibitor dolutegravir, available to low- and middle-income countries at around $75 per person per year." (Photo: NIAID/flickr, CC BY 2.0)