Antiretroviral therapy (ART) advancements have been a major turning point in the fight against HIV/AIDS, turning the once fatal infection into a chronic illness that many people can manage. Yet the latest HIV study has shown that teenage girls are most at risk.
Nonetheless, the development of HIV medication resistance presents a significant obstacle to various international health communities’ attempts to contain the pandemic. The seriousness of this problem was highlighted by a startling discovery made by the World Health Organisation in late 2022: at least 10% of adults living with HIV/AIDS have become resistant to the common class of medication known as non-nucleoside reverse transcriptase inhibitors (NNRTI), especially those who have previously taken ART.
This article examines the two types of resistance, looks at the prevalence and effects of HIV medication resistance, and offers some possible remedies for this issue.
The prevalence and impact of HIV drug resistance
HIV drug resistance is the result of the virus changing such that some drugs that were previously used to stop its replication no longer work. This resistance complicates public health efforts to stop the spread of HIV by jeopardising the effectiveness of treatment for the individual as well as increasing the risk of transmitting resistant strains to others.
Drug-resistant HIV prevalence has been rising, particularly in areas where ART is widely available. Factors like irregular medication adherence, inappropriate prescribing practices, and restricted access to more recent and potent antiretroviral medications aggravate this situation even more.
HIV medication resistance has a variety of effects, including negative effects on patient outcomes, medical expenses, and the general efficacy of HIV prevention programmes. Drug-resistant HIV patients may not respond to first-line treatments, which means they must move to second or third-line therapies, which are often more costly, require more pills, and may have more severe side effects.
As a result, the cost of maintaining healthcare systems rises, and attaining viral suppression at the population level gets harder and harder to do.
The two kinds of HIV drug resistance
It is essential to comprehend the various forms of HIV medication resistance in order to create efficient management plans. There are mainly two types:
A person who contracts an HIV infection with a strain of the virus that is already resistant to some medications develops primary (or transmitted) drug resistance. This type of resistance is especially dangerous because it can drastically reduce the number of first-line treatment regimens that are effective.
People receiving antiretroviral therapy gradually develop acquired drug resistance. Pharmacokinetic variability, suboptimal drug levels, and irregular drug adherence are some of the factors that lead to acquired resistance. In addition to affecting the patient’s ability to respond to treatment, acquired resistance increases the possibility of spreading resistant strains to other people.
What’s the solution?
HIV medication resistance calls for a multifaceted strategy. Enhancing the strength of HIV treatment programmes is crucial, first and foremost. Assuring access to regular viral load monitoring is one way to do this, as it allows for the prompt transition to more efficacious regimens and the early identification of treatment failure. Resistance testing should be a routine practice to help determine which therapies are best for people just starting ART or those who are not responding to treatment.
For people on ART, education and support are essential to enhancing medication adherence, which is a vital component in halting the emergence of resistance. In order to address possible adherence barriers and customise care to meet each patient’s needs, healthcare providers should encourage open communication with their patients.
Broadly speaking, increasing accessibility to a wide range of antiretroviral medications is essential. Because of this diversity, there will always be efficient treatment options, even as resistance patterns change. Furthermore, to support early diagnosis and treatment, public health initiatives should encourage routine HIV testing, including at STD clinics in Singapore. Details regarding the cost of STD testing in Singapore can allay financial worries and promote testing. Initiatives to de-stigmatise HIV-related conditions can also encourage a more candid conversation about sexual health and prevention.
Conclusion
HIV medication resistance is a significant but manageable challenge. We can keep making progress in the global fight against HIV/AIDS if we work together to improve treatment programmes, encourage medication adherence, and increase access to a wider range of antiretroviral therapies.
Additional critical measures to lessen the effects of HIV medication resistance include promoting routine HIV testing in Singapore and addressing associated health concerns within an educated and supportive environment. Maintaining progress and protecting the health of millions of people worldwide will depend on being alert and flexible as the landscape of HIV treatment continues to change.
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