Context:
As per World Health Organization’s (WHO) latest HIV Drug Resistance (HIVDR) Report, resistance to the antiretroviral drug dolutegravir (DTG) is increasing among HIV patients.
- Haiti was the only country to report data from a survey of HIVDR among antiretroviral therapy (ART) naïve infants or infants starting ART for the first time.
About Human Immunodeficiency Virus (HIV)
- A Retrovirus: HIV is a virus that attacks the immune system in the human body.
- Transmission: HIV is primarily spread through the exchange of certain bodily fluids such as blood, semen, vaginal fluids and breast milk.
- Impacts on Human Body:
- Affected the Immune System: HIV demolishes a particular type of White Blood Cells (WBCs) and the T-helper (CD4) cells, which are essential for the body’s ability to fight infections and diseases.
- AIDS: If left untreated, the virus destroys a person’s immune system and they are said to be in the Acquired Immunodeficiency Syndrome stage (AIDS).
- ELISA (Enzyme-Linked Immunosorbent Assay) TEST: It detects and measures antibodies in the blood.
- Treatment:
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- Antiretroviral therapy (ART): Although currently, there are no cures for the infection, it can be managed using antiretroviral therapy.
- Highly Active Antiretroviral Therapy or HAART: The standard treatment consists of a combination of drugs (often called “highly active antiretroviral therapy” or HAART) that suppress HIV replication.
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About Dolutegravir (DTG)
- Antiretroviral Drug: Dolutegravir (DTG), sold under the brand name Tivicay, is an antiretroviral medication used, together with other medication, to treat HIV/AIDS.
- Preferred for HIV Treatment: Since 2018, WHO has recommended dolutegravir as the preferred first- and second-line HIV treatment due to its effectiveness, ease of use and minimal side effects.
Key Highlights of the HIV Drug Resistance (HIVDR) Report:
- A Positive Development:
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- High levels of HIV viral load suppression (>90 per cent) in populations receiving DTG containing antiretroviral therapy (ART).
- Arising Concerns:
- High Number of Cases: The report revealed that the Sustainable Development Goal (SDG) targets are off track, with 1.3 million new HIV infections and 630,000 HIV-related deaths reported in 2022.
- Evidence of Drug Resistance: The worrying evidence of resistance in individuals with unsuppressed viral load despite dolutegravir treatment.
- Survey data from four sources indicate resistance levels ranging from 3.9-8.6%, reaching 19.6% among individuals with high viral loads who transitioned to DTG-containing antiretroviral therapy (ART).
- Transmission to Infants: Haiti reported a unique case where an infant, born to a mother receiving DTG-based ART, showed resistance to DTG.
Recommendations:
- Regular Monitoring: Routine surveillance of HIVDR to track prevalence and patterns of resistance, critical for shaping treatment guidelines and improving programme quality.
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- Routine monitoring of quality-of-care indicators, including on-time ART pick-up and viral load testing coverage, are crucial for successful ART programmes.
- Strengthening of Data Reporting Systems: To monitor and report quality-of-care indicators effectively.
- Quality Enhancement: Target lacking by the countries emphasizing the need for improved quality of treatment and care services.
Also Read: New Class Of Antibiotic Against A Drug-Resistant Bacterium
News Source: Down to Earth
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March 7, 2024