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Increasing levels of pretreatment HIV drug resistance and safety concerns for dolutegravir use in women of reproductive age

Inzaule, Seth Chekataa; Jordan, Michael R.b; Cournil, Amandinec; Vitoria, Marcoa; Ravasi, Giovannid; Cham, Fatime; Le, Linh-Vif; Dzangare, Janetg; Hamunime, Ndapewah; Mutenda, Nicholush; Aghokeng, Avelini; Bissek, Annezj; Billong, Sergek; Kaleebu, Pontianol; Doherty, Mega; Bertagnolio, Silviaa

doi: 10.1097/QAD.0000000000002277
Research Letter
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Use of dolutegravir-based first-line antiretroviral therapy (ART) in response to rising levels of pretreatment HIV drug resistance (PDR) to non-nucleoside reverse transcriptase inhibitors (NNRTIs) may be limited, given safety concerns for birth defects in women of child-bearing potential. Pooled data from 11 nationally representative surveys show that NNRTI PDR in women is nearly twice that in men, exceeding 10% in 8 of 11 countries monitored, suggesting the urgent need for a non-NNRTI-based ART regimen in this population.

aDepartment of HIV and Global Hepatitis Programme, World Health Organization, Geneva, Switzerland

bTufts University School of Medicine, Boston, USA

cU1058 lab, INSERM, University of Montpellier, Montpellier, France

dPan American Health Organization, Washington DC, USA

eWorld Health Organization, Regional Office for Africa, Brazzaville, Congo

fWorld Health Organization, Regional Office for the Western Pacific, Manila, Philippines

gAIDS & TB Unit, Ministry of Health and Child Care, Harare

hDirectorate of Special Programes for HIV, TB, and Malaria, Ministry of Health and Social Services, Windhoek, Namibia

iCentre de Recherche sur les Maladies Emergentes et Reemergentes (CREMER), Virology laboratory IMPM-IRD, IMPM, Yaoundé, Cameroon and Institut de Recherche pour le Développement (IRD) UMI 233, INSERM U1175, Université de Montpellier, Montpellier, France

jHealth Operational Research, Ministry of Public Heath, Cameroon

kNational AIDS Control Commitee, Yaounde, Cameroon

lUganda Virus Research Institute and MRC/UVRI & LSHTM Uganda Research Unit, Entebbe, Uganda.

Correspondence to Silvia Bertagnolio, MD, Department of HIV and Global Hepatitis Programme, World Health Organization, Avenue Appia, Geneva, Switzerland. Tel: +41 79 7288078; e-mail: bertagnolios@who.int

Received 18 August, 2018

Accepted 21 September, 2018

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