Avec l’essor des traitements antirétroviraux (TAR) à base de dolutégravir (DTG) pour soigner les personnes vivant avec le VIH dans le monde, il est important d’estimer la vitesse à laquelle la résistance acquise au DTG apparaît dans les populations sous TAR. Bien que la résistance au DTG ... ne soit pas apparue dans les populations naïves aux TAR incapables de supprimer la charge virale dans les essais cliniques, certains éléments portent à croire que la résistance au DTG peut émerger chez les personnes suivant des schémas thérapeutiques incluant le DTG. L’OMS recommande aux pays qui étendent les TAR incluant le DTG d’accompagner ce déploiement d’une surveillance en routine de la pharmacorésistance more

WHO’s sentinel surveys of acquired HIV resistance to dolutegravir among people receiving dolutegravir-containing antiretroviral therapy is intended for easy and frequent implementation. Results from sentinel surveys provide insight into the prevalence and year-over-year trends of dolutegravir resi ... stance in adults, children and adolescents receiving dolutegravir-based ART. This sentinel method is implemented complementary to WHO-recommended methods for estimating nationally representative levels of acquired HIV drug resistance.  more

HIV drug resistance strategies focus on prevention through adherence and treatment optimization, surveillance to monitor resistance trends, and innovation in new drugs and diagnostics. Key approaches include implementing national action plans, strengthening laboratory capacity for monitoring, and pr ... oviding comprehensive care, especially for vulnerable populations more

HIV-1 drug resistance (HIVDR) genotyping is an essential component of the WHO global HIVDR surveillance strategy. Plasma “gold standard” specimen type for HIVDR genotyping, but its use may not be feasible in rural, remote areas in low- and middle-income countries, since preparing and storing it ... require personnel and laboratory infrastructure that are often lacking. An alternative specimen type is dried blood spots (DBS), which can be made without special laboratory processing. DBS are more easily transported than plasma because they can be shipped at ambient temperature as non-hazardous materials using regular mail or courier services. 3rd edition more

WHO recommends that pre-exposure prophylaxis (PrEP) be offered as an additional prevention choice for HIV-negative individuals at substantial risk of HIV infection as part of combination prevention approaches. HIV drug resistance has been rarely reported among PrEP users who tested HIV positive i ... n randomized controlled trials or open-label studies. However, PrEP-selected HIV drug resistance could potentially negatively impact the effectiveness of treatment options among PrEP users who acquire HIV, since there is a potential for overlapping resistance profiles between antiretroviral drugs used for both PrEP and first-line antiretroviral therapy. more

The aim of the operational framework is to ensure 1) accurate collection, handling, shipment and storage of specimens collected in countries implementing HIV drug resistance surveillance; and 2) the availability of quality-assured HIV genotyping laboratory services producing comparable and reliable ... results at the national, regional and global levels. This publication updates the WHO HIVResNet HIV drug resistance laboratory operational framework published in 2017 and reflects technical and strategic developments over the past three years. more