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World Antimicrobial Awareness Week 2020

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Key definitions

Antimicrobial resistance happens when microorganisms resist the consequences of medicines, making infections tougher to deal with and growing the danger of illness unfold, extreme sickness and death. Combatting antimicrobial resistance is a world
precedence that wants coordinated motion throughout all authorities sectors and ranges of society.

HIV drug resistance is attributable to modifications within the genetic construction of HIV that impacts the power of medication to dam the replication of the virus. Minimizing the emergence and transmission of HIV drug resistance is an important a part of world
efforts to deal with antimicrobial resistance.


Department data notice

Over the previous decade, the world has witnessed unprecedented scale-up of antiretroviral remedy (ART), which has saved the lives of tens of thousands and thousands of individuals. As of December 2019, 25.four million individuals out of an estimated 38 million individuals residing with HIV
have been receiving ART globally. An elevated use of HIV medicines has been accompanied by the emergence of HIV drug resistance, which has additionally steadily elevated in recent times. 

If not prevented, resistance can jeopardize the efficacy of antiretroviral medicine, as proven by a newly printed systematic evaluate and meta-analysis. Resistance can be related to an elevated variety of HIV infections and HIV-associated circumstances and
deaths.

To coordinate the worldwide effort to guard the long-term efficacy of HIV medicines, WHO, in collaboration with HIVResNet, a world HIV resistance community, developed an HIV drug resistance prevention and evaluation technique. The technique gives an summary of WHO-recommended
actions on the nation stage to fight pointless emergence and transmission of drug-resistant HIV.

The 2020 up to date HIV drug resistance technique – which is to be launched earlier than the top of the 12 months – considers classes discovered within the area over the past decade and anticipates the continued scale-up of antiretroviral remedy and HIV pre-exposure
prophylaxis in low- and middle-income international locations throughout an period of transition to dolutegravir-based regimens.

The basis of WHO’s suggestion is the event, by international locations, of a 5-year nationwide motion plan on HIV drug resistance, which is aligned with the 5 key pillars of the Global motion plan on HIV drug resistance:

  1. prevention and response,
  2. monitoring and surveillance,
  3. analysis and innovation,
  4. laboratory capability, and
  5. governance and enabling mechanisms.

The Global HIV Drug Resistance Global Action plan mirrors and is interlinked with the Global motion plan on antimicrobial resistance.  

Standardized surveillance of HIV drug resistance gives international locations with actionable proof that’s used to optimize affected person and population-level therapy outcomes. The surveillance of pretreatment HIV drug resistance (drug resistance current within the virus of individuals beginning or re-starting antiretroviral remedy) informs the nationwide alternative of advisable first-line antiretroviral regimens. WHO has developed survey strategies to watch pretreatment HIV drug resistance
amongst adults and
infants.  

WHO has simply launched the steerage on HIV drug resistance surveillance in international locations scaling up pre-exposure prophylaxis (PrEP).
While it’s universally anticipated that HIV an infection might be an rare occasion amongst populations taking pre-exposure prophylaxis to stop HIV an infection, drug-resistant HIV can emerge within the very small quantity of people that could grow to be contaminated whereas
taking PrEP. This can negatively impression the effectiveness of obtainable antiretroviral therapy choices as a result of the usage of the identical medicine for each prevention and as elements of advisable first-line antiretroviral remedy.

Countries implementing HIV drug resistance surveys are inspired to carry out HIV drug resistance testing at laboratories designated by WHO for the aim of performing HIV drug resistance testing for surveillance.

Map: WHO HIV drug resistance laboratory community

These laboratories are members of the WHO HIVResNet and performance underneath the WHO HIV drug resistance Laboratory Operational Framework.
This second version, simply printed in 2020, displays current technical and strategic developments, together with consideration of next-generation sequencing strategies, updates to plain working procedures and high quality assurance of HIV sequences
such because the integrase gene and assay validation suggestions. The advisable specimen varieties for HIV drug resistance genotyping are plasma or dried blood spots. Dried blood spots ought to be used for HIV drug resistance surveys during which plasma can’t
be dealt with as per WHO suggestions. The WHO handbook for HIV drug resistance testing utilizing dried blood spot specimens,
third version  simply printed in 2020, emphasises finest practices for dried blood spots preparation, storage and delivery, in addition to number of applicable optimistic controls. 

WHO’s HIV drug resistance report 2019 confirmed substantial progress within the surveillance of HIV drug resistance. Between 2004 and 2020, 57 international locations applied surveys of HIV drug resistance utilizing WHO-recommended strategies (see map beneath), and 17 international locations have plans to conduct surveys. Countries
are strongly inspired and supported of their efforts to promptly interpret, disseminate and use HIV drug resistance survey information at nationwide and world ranges to tell therapy coverage decisions and to advocate for sturdy HIVDR prevention and response
efforts.

Map of nations implementing nationwide HIV drug resistance surveys, 2004–2020

 


Webinar 

Join  us for a webinar on “Addressing HIV drug resistance to guard the effectiveness of HIV therapy in celebration of World Antimicrobial Awareness Week 2020 on 20 November from 14:00 to 15:30 CET (Amsterdam, Berlin, Rome, Stockholm, Vienna time)

The webinar will cowl WHO’s technique to watch and response to HIV drug resistance, newest world epidemiological information, new surveillance strategies, and most up-to-date information on resistance to new ARV medicines used for HIV therapy and prophylaxis.


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