Warning on tackling HIV as WHO finds rise in resistance to antiretroviral drugs

HIV drug resistance is on the rise, according to a new report, which found that the number of people with the virus being treated with antiretrovirals had risen to 27.5 million – an annual increase of 2 million.

Four out of five countries with high rates had seen success in suppressing the virus with antiretroviral treatments, according to the World Health Organization’s HIV drug-resistance report.

But the study found an increase in countries reaching a 10% threshold of resistance to a class of drugs which, the WHO said, underlined the need for a move to an alternative treatment, which it has recommended since 2019. Resistance exceeding the 10% threshold was reported in 21 of 30 countries surveyed.

Switching from non-nucleoside reverse transcriptase inhibitors was important for children, the report said, with nearly half of infants newly diagnosed carrying drug-resistant HIV, according to surveys in 10 sub-Saharan African countries.

The WHO said robust monitoring of drug resistance was key for governments with high numbers of HIV patients to ensure that suppression of the virus did not wane. It said 64% of those countries had plans to monitor and tackle drug resistance.

Meg Doherty, director of WHO’s global HIV, hepatitis and STI programmes, said the report held countries accountable for monitoring drug resistance and ensuring effective treatment for patients.

“In the future, we will expand our surveillance to new ARVs [antiretrovirals], and those that are delivered as long-acting agents for prevention and treatment, so that we can maintain our ARVs for the lifetime of people living with HIV,” said Doherty.

According to the report, countries achieving high levels of viral suppression increased from 33% in 2017 to 80% by the end of 2020, which the WHO said prevented transmission and deaths from HIV and slowed the emergence of drug resistance.

WHO’s director general, Dr Tedros Adhanom Ghebreyesus, urged countries to use antimicrobials therapy responsibly to ensure effectiveness.

“Antimicrobials – including antibiotics, antivirals, antifungals and antiparasitics – are the backbone of modern medicine. But the overuse and misuse of antimicrobials are undermining the effectiveness of these essential medicines,” said Tedros. “We can all play a part in preserving antimicrobials and preventing drug resistance.”

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