Juan Louis Mosqueda Gómez

Session was focused on the prevalence of resistance in different countries and populations, which is important to know because it helps to guide the decisions about the preferred first line and subsequent regimens. While transmitted resistance is going down in some places is still increasing in other countries.

Rosana Gonçalves showed data on the declining trend in HIVDR during the last decade in Brazil among ARV-experienced individuals, helping to get high rates of viral suppression among people on ART. Joseph Fokam. Pre-treatment prevalence HIVDR is heterogeneous among regions in Camerun, two regions with EFV/NVP-PDR beyond 10% requiring transition to DTG-based regimens. Rachel Kamba. In Malawi, 30% of children and adolescents are failing to a second-line therapy, getting good rates of viral suppression (86%) when they are put on 3rd line therapy, but access to genotype and medications is difficult. Oladele Vincent. Genotypes were made on women with virologic failure at delivery. Prevalence of DRM were 73%, the predominant DRM were K103N (74%) and M184V (48%). Bangalee showed data from an observational study on plasma samples from patients with LLV in South Africa. Assay success rate was 75%, and 75% of them had DRM mostly related to NNRTI (47%).

Speakers raised concern about the problem of resistance, particularly in the context of vulnerable populations as children, adolescents or pregnant woman. HIVDR remains as threat to get the goal of elimination of MTCT. Access to genotypes and third-line medications are needed in limited-resource settings. There is a need for pediatric formulations of antiretrovirals. There is still a lot of caveats on the understanding and management of patients with LLV.