Background
Current WHO HIV treatment guidelines recommend dolutegravir (DTG)-based ART as the preferred first-line regimen for people living with HIV starting ART. The number of countries adopting DTG as part of the preferred first-line ART has steadily increased. As DTG-based ART for the treatment of HIV expands globally, it is crucial to estimate the extent to which acquired DTG resistance emerges in populations receiving ART.
Cabotegravir long- acting pre- exposure prophylaxis (CAB-LA PrEP), an analogue of DTG, is highly efficacious in preventing HIV infection. However, nearly 1 in 4 persons diagnosed with HIV after receiving CAB-LA PrEP may have cross- resistance to DTG before treatment initiation. Therefore, WHO recommends that surveillance of HIV drug resistance should accompany the scale-up of DTG-containing ART and CAB-LA PrEP in HIV programmes.
WHO has revised and published several methods for the surveillance of acquired HIV drug resistance. A new sentinel method for the surveillance of acquired HIV resistance to DTG was launched during the webinar organised as part of the World Antimicrobial Awareness Week 2022.
Objectives
The webinar launched WHO’s new method of sentinel surveillance of
acquired HIV drug resistance in people receiving dolutegravir-containing
ART. In addition, the webinar updated attendees on:
1. The global transition to dolutegravir-based ART;
2. The prevalence of dolutegravir resistance in low- and middle-income countries;
3.
Dolutegravir drug resistance in persons diagnosed with HIV after
exposure to long-acting injectable cabotegravir for pre-exposure
prophylaxis; and
4. The predicted effects of introduction of long-acting injectable cabotegravir pre-exposure prophylaxis in sub-Saharan Africa.
The session included a discussion by an expert panel.
