HIV resistance to tenofovir

Potent tenofovir-containing antiretroviral regimens are increasingly used to treat and prevent HIV. Few data exist on the frequency of and risk factors for acquired drug resistance in regions hardest hit by the HIV pandemic. This collaborative study combined data from adult treatment cohorts and clinical trials in Europe, Latin and North America, sub-Saharan Africa, and Asia. It created a global assessment of drug resistance after virological failure with first-line regimens containing tenofovir. The study found tenofovir resistance to be surprisingly common in patients with treatment failure in low-income settings. Importantly, these individuals also have significant resistance to other drugs in their regimen. Newly-identified risk factors for tenofovir resistance include lower pre-treatment CD4 cell count and the type of co-administered antiretrovirals in the drug combination. These findings imply that improvements in the quality of HIV care and access to viral load monitoring are urgently needed to mitigate the emergence and spread of tenofovir resistance. Surveillance of drug resistance is high priority to prolonging and sustaining the durability of tenofovir-containing regimens.


Authors: The TenoRes Study Group.


Read the article in The Lancet Infectious Diseases


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