WHO's latest HIV Drug Resistance report sparks a major concern
While it acknowledges significant HIV viral load suppression in populations on dolutegravir (DTG)-based therapy, it also raises alarm over escalating levels of HIV drug resistance (HIVDR) to DTG.
FollowThe World Health Organization's (WHO) latest HIV Drug Resistance (HIVDR) Report sheds light on the growing prevalence of drug resistance and presents a mix of positive and concerning findings. While it notes significant levels of HIV viral load suppression (>90%) in populations receiving dolutegravir (DTG)-containing antiretroviral therapy (ART), it also highlights escalating levels of HIV drug resistance (HIVDR) to DTG, surpassing rates observed in clinical trials.
Background and WHO Recommendations
Since 2018, WHO has endorsed dolutegravir as the preferred first- and second-line HIV treatment due to its efficacy, tolerability, and reduced side effects compared to other drugs. However, recent data from observational surveys indicate varying levels of resistance to DTG, ranging from 3.9% to 8.6%, and peaking at 19.6% among individuals transitioning to DTG-based ART with high viral loads.
Dr Meg Doherty, Director of WHO's Department of the Global HIV, Hepatitis, and STI Programmes, underscores the urgency for heightened vigilance and improved HIV care delivery to address emerging resistance challenges.
Global Targets and Progress
Despite progress in HIV treatment coverage, with over 75% of the 39 million people living with HIV globally receiving treatment, the report highlights stalled progress towards Sustainable Development Goal (SDG) targets. An estimated 1.3 million new HIV infections and 630,000 HIV-related deaths were reported in 2022.
Need for Enhanced Surveillance and Action
The report emphasizes the importance of standardized surveillance of HIVDR to track resistance patterns and inform treatment guidelines. Additionally, it calls for the routine monitoring of quality-of-care indicators at both clinic and national levels to optimize ART programmes and mitigate the emergence of drug-resistant HIV strains.
To minimize the spread of HIV drug resistance, WHO recommends coordinated action across all sectors and levels of society. Strengthening data reporting systems and leveraging indicator data for tailored solutions are essential steps in enhancing service delivery quality and combating antimicrobial resistance on a global scale.
