Around 2.6 million children and adolescents in the world are living with HIV. They have a higher chance of treatment failure as compared to adults. But new research has recently found that regular medication support is more crucial than testing for viral drug resistance. It shows the need for improved treatment in cases where treatment has failed.
The fight against HIV has made significant progress in recent years. Doctors now use antiretroviral drugs to prevent the virus from reproducing and transmitting to others. But some variants of the virus have become resistant to these drugs, and in high-income countries, doctors test the virus for resistance mutations if a particular treatment fails. But such tests are not readily available in resource-limited regions.
Hence doctors may decide to switch to another medication to circumvent resistance or not change the medication if it was not taken daily as intended. Due to limited funding for HIV programs in African countries, experts are discussing the possibility of improving treatment success by providing more resistance tests, particularly for children and adolescents.
This research was titled GIVE MOVE and recently published in the journal The Lancet Global Health. In this study, researchers involved 284 children. These children were aged between 6 months and 19 years. They were receiving antiretroviral therapy, but they still showed a high concentration of the HIV virus in their blood samples. Researchers divided them into two groups.
One group underwent specialist tests for viral mutations causing resistance and the other group received usual care with repeated viral load testing and empirical treatment. In this study, researchers wanted to check the effectiveness of these cost- and labor-intensive tests in better HIV management. This study was conducted at 10 clinical centers in Lesotho and Tanzania.
When researchers observed the results, they found that genetic tests for resistance did not significantly improve treatment. There was no difference in viral load between those two groups as they found similar levels of the virus in their blood samples. It contradicts the assumption that treatment supported by resistance test would significantly improve clinical and virological outcomes.
One of the researchers said that the main reason why the viral load remained high despite taking antiretroviral medications is that people did not take the drugs every day as they were supposed to. He also said that enhancing therapy adherence is more effective than broadening resistance tests. This is important because it helps us decide where to allocate limited funding for HIV programs.
The researchers want their study to help programs for children and teenagers get more resources to improve their treatment. They also want to figure out who is most likely to develop resistance to viruses. Hence, they can give expensive resistance testing to those people.
