Increasing HIV-1 Pretreatment Drug Resistance to NNRTIs in Low- and Middle-Income Countries

Growing pretreatment resistance to nonnucleoside reverse transcriptase inhibitors in many low- and middle-income countries prompts review of therapy recommendations.

The 2016 WHO treatment guidelines recommended a nonnucleoside reverse transcriptase inhibitor (NNRTI)−based regimen for persons older than 3 years initiating or reinitiating HIV-1 treatment, regardless of medication history. Prompted by concerns about transmitted resistance, the authors conducted a systematic review and meta-regression analysis of drug resistance using 358 datasets encompassing 56,044 adults in five regions in 63 countries. They recorded drug resistance prevalence by year, and when possible, analyzed those with and without prior therapy separately.

Although the researchers found little to no change in the development of nucleoside reverse transcriptase inhibitor resistance in these regions, NNRTI resistance had increased sig…

Reviewing Author

Wendy S. Armstrong, MD

Disclosures

Consultant/Advisory BoardNIH Therapeutics and Prevention Data Safety Monitoring Board

Leadership Positions in Professional SocietiesAmerican Board of Internal Medicine Infectious Diseases Subspecialty Board (member), Infectious Diseases Society of America (Vice President)

Wendy S. Armstrong, MD

Disclosures

Consultant/Advisory BoardNIH Therapeutics and Prevention Data Safety Monitoring Board

Leadership Positions in Professional SocietiesAmerican Board of Internal Medicine Infectious Diseases Subspecialty Board (member), Infectious Diseases Society of America (Vice President)

Increasing HIV-1 Pretreatment Drug Resistance to NNRTIs in Low- and Middle-Income Countries

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Reviewing Author