Rising levels of HIV drug resistance

HIV drug resistance is approaching and exceeding 10% in people living with HIV who are about to initiate or reinitiate first-line antiretroviral therapy, according to the largest meta-analysis to date on HIV drug resistance, led by researchers at UCL and the World Health Organization (WHO) and funded by the Bill & Melinda Gates Foundation and the WHO. The study, published today in The Lancet Infectious Diseases , looked at data for people who were beginning antiretroviral therapy, and found that resistance - particularly to one of the main types of first-line drug, NNRTIs - is increasing and those who exhibited drug resistance were more likely to have previously been exposed to antiretroviral drugs, often during pregnancy. "Treatments for HIV have improved immensely in recent years, and close to 21 million people worldwide are now being treated with antiretroviral therapy. Yet to end the AIDS epidemic as a public health threat, minimising drug resistance will be one part of the response. Our findings show the importance of improving how we monitor drug resistance, and suggest we should review which drugs are included in first-line therapies," said the study's lead author, Professor Ravindra Gupta (UCL Infection & Immunity). The researchers pulled together 358 datasets, including data from 56,044 adults across 63 lowto middle-income countries who were beginning first-line therapy for HIV from 1996 and 2016. The research was conducted by a team of 33 authors on five continents.