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Tenofovir resistance may develop in more than half of patients failing treatment in sub-Saharan Africa
Keith Alcorn, 2016-02-01 17:30:00

More than half of people who experienced failure of a tenofovir-based antiretroviral regimen in sub-Saharan Africa had resistance to tenofovir, a meta-analysis of drug resistance studies published in Lancet Infectious Diseases has shown.

The study found that the prevalence of tenofovir resistance after first-line failure ranged from 20% in Western Europe and North America to 56% - 60% in sub-Saharan Africa.

The authors say that their findings suggest that somewhere between 7.5% and 17.5% of people who start treatment in sub-Saharan Africa, with a regimen composed of tenofovir, efavirenz and either lamivudine or emtricitabine, will develop tenofovir resistance after one year, based on current rates of treatment failure. This projection assumes a treatment failure rate of between 15% and 35%, depending on how it is measured, and is in line with recent WHO estimates.

This study does not reflect the prevalence of HIV drug resistance in all people on treatment, nor the prevalence of drug resistance in people who have not yet started treatment, but only the prevalence of drug resistance in people who started specific drug regimens and subsequently experienced virological failure of that treatment regimen.