HIV drug resistance surveillance guidance

Overview

To date, levels of HIV drug resistance (HIVDR) in countries scaling up ART remain manageable; however, they are slowly increasing. For example, in East Africa, resistance rates to non-nucleoside drugs (such as nevirapine and efavirenz) have recently been reported as above 10% .

Although new ART recommendations (“treat all”) and the scale-up of pre-exposure prophylaxis using antiretroviral drugs are likely to further increase levels of HIVDR, concerns about resistant virus should not preclude adoption of a treat-all approach.

To minimize the emergence and spread of HIVDR, the World Health Organization recommends HIV treatment scale-up be accompanied by measures to monitor and improve the quality of ART delivery and surveillance of HIVDR.

This update provides an overview of the essential elements that programme managers should include in programme planning to prevent and monitor the emergence of HIVDR. It also describes programmatic relevance and use of data.