WHO HIV ResNet 2018 meeting report

Overview

WHO convened the HIVResNet meeting in Johannesburg, South Africa, on 21 October 2018. The meeting was attended by 60 HIV drug resistance experts from all over the world. It began with a review of recent changes in the antiretroviral therapy landscape in low- and middle-income countries from the WHO perspective. This includes the addition of dolutegravir (DTG)-based regimens as a preferred option for first-line therapy and observations regarding the safety of DTG for women of childbearing potential. These developments, in the context of increasing rates of pretreatment HIV drug resistance in many countries and especially among women, raise important issues that could affect WHO treatment guidelines. The five pillars of the Global Action Plan and the HIVResNet governance structure were also reviewed. This introduction was then followed by 10 thematically divided sessions of public health relevance.

• Session 1: Sanger versus next-generation sequencing: optimal reporting thresholds for comparability and reproducibility
• Session 2: Could a more affordable genotyping test affect its use in clinical practice in low- and middle-income countries and how?
• Session 3: What is the risk of HIV drug resistance emerging among pre-exposure prophylaxis (PrEP) users in low- and middle-income countries?
• Session 4: Dolutegravir roll-out in the context of non-nucleoside reverse-transcriptase inhibitor (NNRTI) pretreatment HIV drug resistance
• Session 5: How can HIV drug resistance inform antiretroviral therapy switching strategy options?
• Session 6: How do we interpret integrase genotypes for DTG?
• Session 7: What are the challenges and knowledge gaps related to the use of INSTIs in low- and middle-income countries?
• Session 8: Country experience with DTG, viral failure and drug resistance
• Session 9: Doravirine and new drugs in the pipeline: HIV drug resistance profile and potential role in HIV treatment in low- and middle-income countries
• Session 10: How can we monitor progress in addressing the research gaps of the Global Action Plan?