Drug-Resistant HIV Strain Hits Zimbabwe

By Paidamoyo Chipunza
Senior Health
Herald

Two out of 30 HIV-positive people on anti-retroviral therapy (ART) in Zimbabwe have shown signs of resistance to commonly used and most affordable drugs Efavirenz and Nevirapine, the World Health Organisation (WHO) has said.

According to the WHO 2017 HIV drug resistance report, Zimbabwe is among six countries out of 11 from Africa, Asia and Latin America surveyed between 2014 and 2016 whose data showed an increasing trend of this new HIV strain.

The other five countries are Namibia, Uganda, Nicaragua, Argentina and Guatemala.

Data from the six countries, the report said, showed that they had over 10 percent of people on ART resistant to the two drugs.

This data was compiled from adults initiating treatment, children under 18 months newly diagnosed of HIV and adults on treatment.

No immediate comment on the trend could be obtained from local HIV and Aids programming officials.

WHO has since issued new treatment guidelines for HIV and urged countries to monitor their HIV and Aids treatment programmes to mitigate possibility of another epidemic.

WHO director for HIV department and global hepatitis programme Dr Gottfried Hirnschall said governments should ensure treatment adherence to prevent drug resistant HIV.

Dr Hirnschall said countries must therefore monitor the quality of their treatment programmes and take action as soon as treatment failure is detected.

"We need to ensure that people who start treatment can stay on effective treatment, to prevent the emergence of HIV drug resistance.

"When levels of HIV drug resistance become high, we recommend that countries shift to an alternative first-line therapy for those who are starting treatment," said Dr Hirnschall.

WHO director-general Dr Tedros Adhanom Ghebreyesus said once a threshold of 10 percent of people showing signs of drug resistant HIV is reached, countries must urgently review their HIV treatment programmes.

"Antimicrobial drug resistance is a growing challenge to global health and sustainable development," he said.

"We need to proactively address the rising levels of resistance to HIV drugs if we are to achieve the global target of ending AIDS by 2030."

Interim executive director for the Global Fund to Fight Aids, Tuberculosis and Malaria Dr Marijke Wijnroks said this growing threat could undermine global progress in treating and preventing HIV transmission.

Dr Wijnroks urged countries to conduct HIV drug resistant surveys to establish the magnitude of the burden at each country level and consider reprogramming to accommodate this looming epidemic.

"We strongly recommend implementing WHO recommendations for early warning indicators and HIV drug resistance surveys in every national plan for antiretroviral therapy, and to consider funding them through Global Fund grants or reprogramming," said Dr Wijnroks.

According to WHO, HIV drug resistance develops when people do not adhere to a prescribed treatment plan, often because they do not have consistent access to quality HIV treatment and care. Individuals with HIV drug resistance will start to fail therapy and may also transmit drug-resistant viruses to others. The level of HIV in their blood will increase, unless they change to a different treatment regimen, which could be more expensive.

Statistics from the National Aids Council (NAC) shows that an estimated 1,2 million people were living with HIV in Zimbabwe from which 86 percent were on ART.

HIV is one of the diseases that are fast becoming resistant to common and known treatments- a process medically known as anti-microbial resistance.

Other diseases include tuberculosis, sexually transmitted infections such as gonorrhoea, malaria and influenza.