Resistance to key HIV drug ’concerningly common’

HIV drug resistance to tenofovir, an antiretroviral drug vital to most modern HIV treatment and prevention strategies, is surprisingly and worryingly common according to a large study led by UCL and funded by the Wellcome Trust. The research, co-authored by researchers at Stanford University and the London School of Hygiene and Tropical Medicine and published in the Lancet Infectious Diseases journal, studied 1,926 HIV patients across the world with uncontrolled HIV despite being prescribed antiretrovirals. They found tenofovir-resistant strains in 60% of patients in sub-Saharan Africa in contrast to 20% amongst patients treated in Europe. Around two-thirds of patients with tenofovir-resistant strains had also become resistant to both other drugs in their regimen, indicating that their treatment had been completely compromised. The study suggests that in Sub-Saharan Africa, up to 15%* of HIV patients treated with tenofovir-based drug combinations will develop tenofovir resistance in the first year of treatment alone, with this figure rising over time. Resistant strains could be passed on to other individuals, becoming more widespread and potentially compromising global HIV control strategies. "Tenofovir is a critical part of our armamentarium against HIV, so it is extremely concerning to see such a high level of resistance to this drug," explains lead author Dr Ravi Gupta (UCL Infection & Immunity), who is also an Honorary Consultant in Infectious Diseases at University College London NHS Foundation Trust.