HIV drug resistance surveillance concept notes
In 2004, WHO in collaboration with HIVResNet developed a global strategy for surveillance and monitoring of HIV drug resistance (HIVDR).
As part of the strategy, WHO developed surveillance methods to assess the prevalence of HIVDR.
The current concept notes are available below:
1. HIVDR in adult populations starting ART (pre-treatment HIVDR) and HIVDR in adult populations receiving ART (acquired HIVDR)
These two new surveillance methods replace a previous prospective approach. The surveillance method for pre-treatment HIVDR yields a nationally representative estimate of HIVDR in populations initiating ART. The surveillance method for acquired HIVDR yields a nationally representative estimate of viral load suppression and acquired HIVDR. The methods provide results relevant for ART programme level decision making and have built-in flexibility for country adaptation. WHO and partners are working to develop a concept note to assess acquired HIVDR in paediatric populations receiving ART.
National surveys should be undertaken using the new concept notes.
Download current HIVDR surveillance concept notes
Surveillance of HIV drug resistance in adults initiating antiretroviral therapy (pre-treatment HIV drug resistance)
Surveillance of HIV drug resistance in adults receiving ART (acquired HIV drug resistance)
2. HIVDR in infants less than 18 months of age
Surveillance of HIVDR among HIV-infected children less than 18 months of age is important for improving health outcomes and minimizing HIVDR in this population. This survey method uses remnant dried blood spot specimens from a representative sample of children less than 18 months of age being tested for early infant diagnosis. HIVDR genotyping results generated from this survey will support choice of first-line ART in this population.
Protocol for surveillance of initial drug-resistant HIV-1 among children less than 18 months of age newly diagnosed with HIV
3. HIVDR in recently infected populations (transmitted HIV drug resistance)
The survey method using truncated sequential sampling which provided a prevalence classification of transmitted HIVDR in a specific geographic area is no longer recommended by WHO. WHO and partners are working to develop a new concept note which will provide a national statistic of transmitted HIVDR in recently infected populations. The concept note will be posted as soon as it becomes available.