Hidden Drug Resistant HIV to Emerge in the Era of Universal Treatment Access in Southeast Asia |
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| Authors: | Alexander Hoare Stephen J. Kerr Kiat Ruxrungtham Jintanat Ananworanich Matthew G. Law David A. Cooper Praphan Phanuphak David P. Wilson |
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| Affiliation: | 1. National Centre in HIV Epidemiology and Clinical Research, The University of New South Wales, Sydney, Australia.; 2. The HIV Netherlands Australia Thailand Research Collaboration, The Thai Red Cross AIDS Research Centre, Bangkok, Thailand.; 3. Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.;McGill University AIDS Centre, Canada |
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| Abstract: | BackgroundUniversal access to first-line antiretroviral therapy (ART) for HIV infection is becoming more of a reality in most low and middle income countries in Asia. However, second-line therapies are relatively scarce.Methods and FindingsWe developed a mathematical model of an HIV epidemic in a Southeast Asian setting and used it to forecast the impact of treatment plans, without second-line options, on the potential degree of acquisition and transmission of drug resistant HIV strains. We show that after 10 years of universal treatment access, up to 20% of treatment-naïve individuals with HIV may have drug-resistant strains but it depends on the relative fitness of viral strains.ConclusionsIf viral load testing of people on ART is carried out on a yearly basis and virological failure leads to effective second-line therapy, then transmitted drug resistance could be reduced by 80%. Greater efforts are required for minimizing first-line failure, to detect virological failure earlier, and to procure access to second-line therapies. |
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