Abstract:

HIV drug resistance is a major threat to the success of the UNAIDS-launched 90-90-90 target, to be achieved by 2020 and to the elimination of AIDS as a global public health problem. People living with HIV who fail Antiretroviral Therapy (ART) are at a high risk of developing HIV drug resistance, which may be transmitted to others and persons who are infected with a drug resistant strain are at high risk of developing treatment failure. Recent global efforts as well as World Health Organisation (WHO) guidelines recommend the use of Dolutegravir (DTG) as a primary or alternative first-line regimen globally. India has the third largest HIV population in the world and will surely be impacted by these guidelines. Yet the impact of incorporation of DTG on treatment outcomes including drug resistance is unknown, and its investigation is essential before and in parallel to the complete transition to DTG-based first-line therapy. In this study we comprehensively examine HIV Drug Resistance (DR) patterns in circulating RNA and proviral DNA of individuals who are starting DTG-based ART.