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Casting a Wide Net: HIV Drug Resistance Monitoring in Pre-Exposure Prophylaxis Seroconverters in the Global Evaluation of Microbicide Sensitivity Project



Levy, L;

Peterson, JM;

Kudrick, LD;

Chohan, B;

Bosek, E;

Mukui, I;

Mugambi, M;

Nelson, A; + view all

Levy, L;

Peterson, JM;

Kudrick, LD;

Chohan, B;

Bosek, E;

Mukui, I;

Mugambi, M;

Masyuko, S;

Mugurungi, O;

Ndlovu, N;

Mahaka, I;

Dunbar, M;

Hettema, A;

Kuwengwa, RAP;

Matse, S;

Mullick, S;

Greener, L;

O’Connor, C;

Pillay, D;

Fawzy, M;

Mellors, JW;

Parikh, UM;

Mellors, JW;

Parikh, UM;

McCormick, K;

Penrose, K;

Heaps, A;

Richardson, B;

Chandran, U;

Sethi, R;

Phillips, A;

Nakagawa, F;

Cambiano, V;

Levy, L;

Torjesen, K;

Yacobson, I;

Homan, R;

Fawzy, M;

Peterson, JM;

Wallis, C;

Chohan, B;

Dunbar, M;

Ndlovu, N;

Castor, D;

Claypool, L;

Sims, L;

Allen, S;

Nelson, A;

– view fewer

(2022)

Casting a Wide Net: HIV Drug Resistance Monitoring in Pre-Exposure Prophylaxis Seroconverters in the Global Evaluation of Microbicide Sensitivity Project.

Global Health Science and Practice
, 10
(2)


, Article e2100122. 10.9745/GHSP-D-21-00122.

Abstract

Background: Evidence of HIV drug resistance (HIVDR) in individuals using oral pre-exposure prophylaxis (PrEP) who acquire HIV is limited to clinical trials and case studies. More data are needed to understand the risk of HIVDR with oral PrEP during PrEP rollout. Mechanisms to collect these data vary, and are dependent on cost, scale of PrEP distribution, and in-country infrastructure for the identification, collection, and testing of samples from PrEP seroconverters. / Methods: The Global Evaluation of Microbicide Sensitivity (GEMS) project, in collaboration with country stakeholders, initiated HIVDR monitoring among new HIV seroconverters with prior PrEP use in Eswatini, Kenya, South Africa, and Zimbabwe. Standalone protocols were developed to assess HIVDR among a national sample of PrEP users. In addition, HIVDR testing was incorporated into existing demonstration projects for key populations. / Lessons learned: Countries are supportive of conducting a timelimited evaluation of HIVDR during the early stages of PrEP rollout. As PrEP rollout expands, the need for long-term HIVDR monitoring with PrEP will need to be balanced with maintaining national HIV drug resistance surveillance for pretreatment and acquired drug resistance. Laboratory capacity is a common obstacle to setting up a monitoring system. / Conclusions: Establishing HIV resistance monitoring within PrEP programs is feasible. Approaches to drug resistance monitoring may evolve as the PrEP programs mature and expand. The methods and implementation support offered by GEMS assisted countries in developing methods to monitor for drug resistance that best fit their PrEP program needs and resources.

Type: Article

Title: Casting a Wide Net: HIV Drug Resistance Monitoring in Pre-Exposure Prophylaxis Seroconverters in the Global Evaluation of Microbicide Sensitivity Project
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.9745/GHSP-D-21-00122
Publisher version: https://doi.org/10.9745/GHSP-D-21-00122
Language: English
Additional information: Copyright © Levy et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit https://creativecommons.org/licenses/by/4.0/.
Keywords: Anti-HIV Agents, Anti-Infective Agents, Drug Resistance, HIV Infections, Humans, Pre-Exposure Prophylaxis
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute for Global Health > Infection and Population Health
URI: https://discovery.ucl.ac.uk/id/eprint/10163660
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