HIV Drug Resistance Report - November 2021

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HIV drug resistance (HIVDR) can compromise the effectiveness of antiretroviral therapy (ART) in reducing HIV incidence and HIV-associated morbidity and mortality. Minimizing the spread of HIVDR is a critical aspect of the broader global response to antimicrobial resistance.

WHO recommends that countries routinely implement nationally representative HIVDR surveys. The WHO HIV drug resistance report 2021 shows substantial progress in the implementation of HIVDR surveillance. Between 2014 and 2021, 56 countries implemented HIVDR surveys using WHO-recommended methods. The HIV drug resistance report 2021 summarizes findings from 38 countries that had finalized the surveys by the time of this report and shared data with WHO.

Pretreatment HIVDR to non-nucleoside reverse-transcriptase inhibitors (NNRTI) can affect more than 10% of adults starting therapy and is found up to 3 times more often in people who had previous exposure to antiretroviral drugs. In addition, nearly half of infants newly diagnosed with HIV has HIVDR to NNRTI before initiating treatment.The high levels of observed NNRTI pretreatment HIVDR among emphasize the need to** fast-track the transition to WHO-recommended dolutegravir-based ART**.

Among adults failing NNRTI-based first-line ART, the levels of resistance to these drugs ranged from 50% to 97%. The high levels of HIVDR among individuals with treatment failure, emphasize the need to** scale up viral load testing and enhanced adherence counselling and promptly switch individuals with treatment failure**.