Globally, around 2.6 million children and adolescents are living with HIV, predominantly in Africa. These young individuals often face greater challenges with treatment efficacy compared to adults. It was previously believed that testing for viral drug resistance could enhance treatment outcomes in cases of failure.
However, a recent study led by the University of Basel reveals that ensuring regular medication adherence is crucial for improving treatment success.
Significant progress has been made in the fight against HIV through the use of antiretroviral drugs, which effectively control the virus and prevent its transmission. In high-income countries, doctors commonly test for viral resistance mutations if a treatment regimen fails.
This approach is less feasible in resource-limited regions, where such tests are not widely available. In these areas, when treatment fails, doctors often change medications based on assumptions rather than concrete data.
In regions with limited HIV resources, such as many African countries, there is ongoing debate about the potential benefits of expanding resistance testing.
Researchers, including those led by Professor Niklaus Labhardt at the University of Basel, investigated whether these costly and labor-intensive tests could improve treatment outcomes. Their study, published in The Lancet Global Health, examines whether resistance testing is an effective strategy.
The study, conducted in Lesotho and Tanzania with 284 participants aged six months to 19 years, showed that resistance testing did not significantly improve treatment outcomes.
Both the group receiving resistance tests and the group with standard care showed no significant difference in viral load after 36 weeks. This suggests that the assumption that resistance tests would enhance treatment efficacy is not supported by the data.
The key finding from this research is that improving adherence to medication is more effective than the broader use of resistance testing. The study underscores the importance of focusing on interventions that enhance adherence to treatment, given the limited resources available.
The researchers advocate for better-targeted resistance testing and more support for programs addressing the specific needs of young people with HIV to improve their treatment adherence and overall outcomes.
