HIV Drug Resistance emerges when HIV replicates in the presence of antiretroviral drugs. If HIV drug resistance becomes widespread, the drugs currently used to treat HIV infection may become ineffective. To date, levels of HIV Drug Resistance in countries scaling up ART remain manageable. However, resistance is slowly increasing: in East Africa, resistance rates of 10% to non-nucleoside drugs (such as nevirapine and efavirenz) have been recently described.
To maximize the long-term effectiveness of first-line ART regimens, and ensure the sustainability of ART programmes, it is essential to minimize the further spread of HIV drug resistance. Even in settings with optimal ART programme management, some degree of HIVDR is expected to emerge in populations on ART and some HIVDR is expected to be transmitted to previously uninfected individuals. Therefore, WHO recommends that HIV treatment scale-up should always be accompanied by a robust assessment of drug resistance emergence and transmission.
Keywords: HIV, ART, treatment, prevalence, clinics, adults