WHO Warns of Rising Resistance to Key HIV Medication

The World Health Organization (WHO) has highlighted a concerning trend of resistance to dolutegravir, a widely used medication in HIV management in a recent report.

Dolutegravir, an antiretroviral medication often prescribed alongside other drugs for HIV patients, has been endorsed by the WHO since 2018 as the preferred treatment option for individuals of all ages and populations due to its minimal side effects compared to similar medications.

However, recent surveys conducted by the WHO have revealed resistance rates to dolutegravir ranging from 3.9 percent to 8.6 percent, with one report showing a peak resistance level of 19.6 percent.

In a statement, the Director of the WHO’s Department of the Global HIV, Hepatitis and STI Programmes, Meg Doherty, noted that: “The worrying evidence of resistance in individuals with unsuppressed viral load despite dolutegravir treatment underscores the necessity for increased vigilance and intensified efforts to optimize the quality of HIV care delivery.

“Standardized surveillance of HIV drug resistance is essential for effectively preventing, monitoring, and responding to these challenges,” she noted.

The importance of utilizing longacting cabotegravir (CAB-LA) for pre-exposure prophylaxis, commonly referred to as PrEP, was further emphasized in the report due to its significant reduction in the risk of acquiring HIV.

In rare cases, the combination has yielded some delayed detection of HIV cases, but the WHO noted that despite this, “the roll-out of CAB-LA for PrEP should not be hindered,” adding that the “scale-up of PrEP should be accompanied by standardized surveillance of drug resistance among people testing positive for HIV while receiving PrEP.”

HIV drug resistance can occur, but it is uncommon and typically emerges in individuals who do not consistently adhere to their antiretroviral medication regimen. When taken as prescribed, ART is highly effective in preventing HIV from replicating and preventing transmission.

According to WHO, antiretroviral therapy (ART) remains highly effective in suppressing HIV replication, preventing immune system decline and disease progression, and reducing the risk of HIV transmission.

“When people living with HIV adhere to antiretroviral therapy, the virus becomes undetectable in their blood and they cannot transmit the virus to others. This is known as treatment as prevention. Early diagnosis, treatment, and viral suppression are essential to ending AIDS as a public health threat by 2030.”