ZIMBABWE is among one of the 18 countries that recorded HIV drug resistance above 10% percent amidst indications that more women showed resistance to first line regimens efavirenz/nevirapine.
In the SADC region, South Africa tops the list with a 23.6% Pretreatment Drug Resistance (PDR) to efavirenz/nevirapine followed by Namibia which has a 13.8% PDR to EFV/NVP while Zimbabwe has 10.9% PDR to EDF/NVP. However, national guidelines in all these countries have been revised to include the use of DTG as preferred first-line ART for adults and adolescents (in women and girls of childbearing potential through informed choice).
According to the World Health Organization (WHO) Drug Resistance Report for 2019, the high levels of drug resistance in the countries that were studied in the report which include Zimbabwe highlight the need to fast-track the transition to dolutegravir-based first-line regimens in adults and to use PIs in circumstances where levels of PDR are high and the use of dolutegravir is not feasible as per WHO recommendations.
PDR in countries is varied. In countries in Central and Latin America the levels of PDR to NNRTIs were particularly high, especially in women, suggesting the need to strengthening the health systems, and in particular, to increase access of women to continued and reliable ARV provision.
“The low prevalence of TDF/ XTC resistance provides reassurance for using this drug combination in PrEP; however, since these two drugs are used in combination as PrEP and as a component of ART first-line regimens, routine surveillance is required to provide continual assurance that these two ARV drugs can be effectively used as both treatment and prophylaxis when PrEP programmes are scaled up in low- and middleincome countries.”
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