By Rudo Shoko

DRUG resistance has in recent times become a major global health concern as diseases are fast becoming resistant to common and known treatment.
According to the World Health Organisation (WHO) latest 2017 HIV drug resistance Report, Zimbabwe is among six countries out of 11 from Africa, Asia and Latin America surveyed between 2014 and 2016 whose data showed an increasing trend of a new HIV strain.
The report says two of 30 HIV positive people on anti-retroviral therapy (ART) in Zimbabwe have shown signs of resistance to commonly used and affordable drugs efavirenz and nevirapine.
The report states that resistance to treatment can happen in part when people do not have access to high-quality HIV treatment and care and cannot take their full regimen of medication.
The resistance can also develop when people do not adhere to a prescribed treatment plan, often because they do not have consistent access to quality HIV treatment and care.
“Antimicrobial drug resistance is a growing challenge to global health and sustainable development,” said Dr Tedros Adhanom Ghebreyesus, the new director-general of WHO in a statement.
“We need to proactively address the rising levels of resistance to HIV drugs if we are to achieve the global target of ending AIDS by 2030.”
HIV is fast becoming resistant to common and known treatment, a process medically known as anti-microbial resistance.
Other diseases that have developed anti-microbial resistance include tuberculosis, malaria, influenza and sexually transmitted infections such as gonorrhea among others.
A health expert who refused to be named told Patriot Health the ability of HIV to mutate and reproduce itself in the presence of antiretroviral drugs is called HIV drug resistance (HIVDR).
“The consequences of HIVDR include treatment failure and further spread of drug-resistant HIV,” he said.
“This can compromise the effectiveness of the limited therapeutic options to reach the last 90 percent target (of achieving viral suppression) and further reduce HIV incidence, mortality and morbidity.
“Drug-resistance testing is also recommended for all HIV-infected pregnant women before starting HIV treatment and also in some pregnant women already taking HIV medicines.
“Pregnant women will work with their health care providers to decide if drug-resistance testing is needed.”
Drug-resistance testing is done to identify which, if any, HIV medicines will not be effective against a person’ strain of HIV.
Drug-resistance testing is done using a sample of blood.
Medical experts say that as HIV multiplies in the body, the virus sometimes mutates (changes form) and produces variations of itself.
Variations of HIV that develop while a person is taking HIV medicines can lead to drug-resistant strains of HIV.
With drug resistance, HIV medicines that previously controlled a person’s HIV are not effective against new, drug-resistant HIV.
In other words, the HIV medicines cannot prevent the drug-resistant HIV from multiplying.
Drug resistance can cause HIV treatment to fail.
A person can initially be infected with drug-resistant HIV or develop drug-resistant HIV after starting on HIV medicines.
Research also states that drug-resistance testing can identify which, if any, HIV medicines will not be effective against a person’s HIV.
Drug-resistance testing results help determine which HIV medicines to include in an HIV treatment regimen.
Individuals with HIV drug resistance will start to fail therapy and may also transmit drug-resistant viruses to others sexually.
The level of HIV in their blood will increase, unless they change to a different treatment regimen, which could be more expensive and, in many countries, still harder to obtain.
Drug-resistance testing is done when a person first begins receiving care for HIV infection.
Resistance testing should be done whether the person decides to start taking HIV medicines immediately or to delay treatment.
If treatment is delayed, resistance testing may be repeated when HIV treatment is started.
After treatment is started, drug-resistance testing is repeated if viral load testing indicates that a person’s HIV regimen isn’t controlling the virus.
If drug-resistance testing shows that the HIV regimen is not effective because of drug resistance, the test results can be used to select a new HIV regime.
Statistics from the National Aids Council (NAC) show that an estimated 1,2 million people are living with HIV/AIDS in Zimbabwe.