Pre-treatment HIV drug resistance testing cost-effectiveness

By David AMC van de Vijver  Brooke Nichols  |  | 

Duarte and colleagues addressed HIV drug resistance as part of clinical care. HIV drug resistance testing, however, is also used for surveillance purposes in which the occurrence of resistance associated mutations is studied in a sample of people living with HIV that initiate treatment or who showed virological failure while on antiretroviral therapy. These surveillance programs allow the timely identification of wide-spread transmission and emergence of drug
resistance which in turn could necessitate a change in treatment [6]. As a consequence, surveillance programs using drug resistance testing should be continued as part of public health programs. The study by Duarte and colleagues further adds to the body of evidence that, given the regimens available now and the current rates of transmitted drug resistance, pre-treatment drug resistances testing is unlikely to be cost-effective. Resources should instead continue
to focus on consistent annual viral load monitoring and a timely switch to second-line regimen if required.

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Elsevier EClinicalMedicine