HIV Drug Resistance in Children and Adolescents: Always a Challenge?

• Published in: Current epidemiology reports Vol. 8; no. 3; pp. 97 - 107
• Main Authors: Koay, Wei Li A., Kose-Otieno, Judith, Rakhmanina, Natella
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 2021; Springer Nature B.V
• Subjects: Adolescents; Antiretroviral agents; Antiviral agents; Children; Disease transmission; Drug resistance; Epidemiology; Health risks; HIV; Human immunodeficiency virus; Infectious Disease Epidemiology (M Yotebieng; Infectious Disease Epidemiology (M Yotebieng, Section Editor); Inhibitors; Integrase; Medicine; Medicine & Public Health; Morbidity; Non-nucleoside reverse transcriptase inhibitors; Pediatrics; RNA-directed DNA polymerase; Section Editor; Topical Collection on Infectious Disease Epidemiology; Children; HIV; Adolescents; Antiretroviral resistance; Pre-exposure prophylaxis; Prevention of mother-to-child transmission
• ISSN: 2196-2995; 2196-2995
• DOI: 10.1007/s40471-021-00268-3

Purpose of Review
With the expanded roll-out of antiretrovirals for treatment and prevention of HIV during the last decade, the emergence of HIV drug resistance (HIVDR) has become a growing challenge. This review provides an overview of the epidemiology and trajectory of HIVDR globally with an emphasis on pediatric and adolescent populations.
Recent Findings
HIVDR is associated with suboptimal virologic suppression and treatment failure, leading to an increased risk of HIV transmission to uninfected people and increased morbidity and mortality among people living with HIV. High rates of HIVDR to non-nucleoside reverse transcriptase inhibitors globally are expected to decline with the introduction of the integrase strand transfer inhibitors and long-acting combination regimens, while challenge remains for HIVDR to other classes of antiretroviral drugs.
Summary
We highlight several solutions including increased HIV viral load monitoring, expanded HIVDR surveillance, and adopting antiretroviral regimens with a high-resistance barrier to decrease HIVDR. Implementation studies and programmatic changes are needed to determine the best approach to prevent and combat the development of HIVDR.