HIV drug resistance
WHO/Europe’s public health principles to minimize emergence of HIV drug resistance (HIVDR) include:
- ensuring appropriate access, prescribing and use of antiretroviral therapy (ART);
- fostering adherence;
- supporting prevention of HIV transmission; and
- promoting appropriate action based on surveillance and monitoring results.
Programme elements to implement these principles include:
- use of standard highly active ART regimens (selected for the area’s needs);
- quality assurance for antiretroviral drugs (ARVs);
- adequate and continuous drug supplies;
- standardized individual treatment records;
- support for and monitoring of adherence;
- removal of barriers to continuous access to care;
- prevention programmes to reduce HIV transmission from persons in treatment;
- HIVDR laboratory-based surveillance to assess transmitted drug resistance in newly infected individuals; and
- institutionalized monitoring of key measures which may be affected programmatically to minimize the emergence of HIVDR.
A national HIVDR prevention and assessment strategy includes:
- a national HIVDR working group;
- a plan for the detection of early warning signs;
- surveys to monitor HIVDR prevention and associated factors;
- surveillance of transmitted HIVDR in recently infected individuals;
- designation of one or more genotyping laboratories for surveillance and monitoring;
- a national HIVDR database; and
- annual reports and recommendations.
