The World Health Organization (WHO) has released a concise report highlighting a concerning trend in HIV drug resistance (HIVDR) in the integrase strand transfer inhibitors (INSTI) era. The report notes the high efficacy of dolutegravir (DTG)-based antiretroviral therapy (ART) in suppressing viral loads, exceeding 90%. However, it warns that HIVDR to DTG is emerging at higher rates than clinical trials predicted, with resistance levels ranging from 3.9% to 19.6% among surveyed populations.
The WHO emphasizes the necessity for countries to implement standardized HIVDR surveillance to monitor resistance patterns, especially among those not achieving viral suppression on DTG-based ART. Additionally, the report acknowledges the benefits of long-acting cabotegravir (CAB-LA) for pre-exposure prophylaxis (PrEP), while cautioning about the observed INSTI resistance in some cases. It advocates for continued PrEP scale-up, complemented by robust drug resistance surveillance to mitigate the risk of INSTI resistance-associated mutations.
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