Abstract:
A study measuring HIV drug resistance at two timepoints in Kenyan patients on second-line, protease inhibitor-based regimens has found very high levels of drug resistance in people with detectable viral loads.
Unexpectedly, it found higher rates of resistance in people with what it called ‘low level viraemia’ (defined as viral loads from 40 to 1000 copies/ml) than it did in people with viral loads over 1000 copies/ml. It also found continued accumulation of new HIV resistance mutations in these people.
The study suggests that current treatment failure guidelines may need to be revised – and poses the question of how to resource them.