Steegen Kim, van Zyl Gert U, Claassen Mathilda, Khan Aabida, Pillay Melendhran, Govender Subitha, Bester Phillip A, van Straaten Johanna M, Kana Vibha, Cutler Ewaldé, Kalimashe Monalisa N, Lebelo Ramokone L, Moloi Mokopi B H, Hans Lucia
Department of Molecular Medicine and Haematology, National Health Laboratory Service, Charlotte Maxeke Johannesburg Hospital, Johannesburg 2193, South Africa.
Department of Molecular Medicine and Haematology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa.
Diagnostics (Basel). 2023 Jun 29;13(13):2209. doi: 10.3390/diagnostics13132209.
Monitoring of HIV drug resistance (HIVDR) remains critical for ensuring countries attain and sustain the global goals for ending HIV as a public health threat by 2030. On an individual patient level, drug resistance results assist in ensuring unnecessary treatment switches are avoided and subsequent regimens are tailored on a case-by-case basis, should resistance be detected. Although there is a disparity in access to HIVDR testing in high-income countries compared to low- and middle-income countries (LMICS), more LMICs have now included HIVDR testing for individual patient management in some groups of patients. In this review, we describe different strategies for surveillance as well as where HIVDR testing can be implemented for individual patient management. In addition, we briefly review available technologies for HIVDR testing in LMICs, including Sanger sequencing, next-generation sequencing, and some point-of-care options. Finally, we describe how South Africa has implemented HIVDR testing in the public sector.
监测艾滋病毒耐药性（HIVDR）对于确保各国实现并维持到2030年将艾滋病毒作为公共卫生威胁消除的全球目标仍然至关重要。在个体患者层面，耐药性检测结果有助于避免不必要的治疗方案切换，并在检测到耐药性时根据具体情况定制后续治疗方案。尽管与低收入和中等收入国家（LMICs）相比，高收入国家在获得HIVDR检测方面存在差距，但现在更多的低收入和中等收入国家已将HIVDR检测纳入某些患者群体的个体患者管理中。在本综述中，我们描述了不同的监测策略以及可在何处实施HIVDR检测以进行个体患者管理。此外，我们简要回顾了低收入和中等收入国家可用的HIVDR检测技术，包括桑格测序、下一代测序和一些即时检测选项。最后，我们描述了南非如何在公共部门实施HIVDR检测。
