HIV remains a major public health challenge globally. Around 38 million people are estimated to be living with the infection. Sub-Saharan Africa bears the brunt of the HIV epidemic. Close to two thirds of the HIV cases are in the region.
– over 1,000 copies/ml, as per the World Health Organization guidelines. This means drug resistant HIV variants in patients with low viral loads aren’t detected. This is the case in many countries in sub-Saharan Africa – including Botswana.Firstly, what percentage of patients on ART had low HIV viral loads. This is data that’s never been collected before. Secondly, we wanted to determine HIV drug resistant mutations in this cohort of patients.
We recommend that patients on ART with detectable viral loads above 50 copies/ml be further investigated to ensure that they don’t harbour drug resistant HIV variants. The figure of 8% may seem low. But it means that this cohort either has a resistant variant, or their treatment isn’t working. Current treatment guidelines describe virologic failure as viral loads above 1,000 copies/ml. Our results challenge this.