Advancing HIV Drug Resistance Technologies and Strategies: Insights from South Africa’s Experience and Future Directions for Resource-Limited Settings

Kim Steegen*, Gert U. van Zyl, Mathilda Claassen, Aabida Khan, Melendhran Pillay, Subitha Govender, Phillip A. Bester, Johanna M. van Straaten, Vibha Kana, Ewaldé Cutler, Monalisa N. Kalimashe, Ramokone L. Lebelo, Mokopi B.H. Moloi, Lucia Hans

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

1 Citation (Scopus)

Abstract

Monitoring of HIV drug resistance (HIVDR) remains critical for ensuring countries attain and sustain the global goals for ending HIV as a public health threat by 2030. On an individual patient level, drug resistance results assist in ensuring unnecessary treatment switches are avoided and subsequent regimens are tailored on a case-by-case basis, should resistance be detected. Although there is a disparity in access to HIVDR testing in high-income countries compared to low- and middle-income countries (LMICS), more LMICs have now included HIVDR testing for individual patient management in some groups of patients. In this review, we describe different strategies for surveillance as well as where HIVDR testing can be implemented for individual patient management. In addition, we briefly review available technologies for HIVDR testing in LMICs, including Sanger sequencing, next-generation sequencing, and some point-of-care options. Finally, we describe how South Africa has implemented HIVDR testing in the public sector.

Original languageEnglish
Article number2209
JournalDiagnostics
Volume13
Issue number13
DOIs
Publication statusPublished - Jul 2023

Keywords

  • HIV drug resistance testing
  • acquired drug resistance
  • next-generation sequencing
  • pretreatment drug resistance
  • surveillance

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