Tools to stop HIV drug resistance
HIV continues to evolve ahead of new antiretroviral drug development and there are many areas of drug resistance that are poorly understood. Real-time monitoring tools are required to predict new resistance mechanisms and determine how the virus changes in response to molecular and social changes. The EU-funded CHAIN (Collaborative HIV and anti-HIV drug resistance network) project fought against HIV drug resistance at a transcontinental level. The project achieved this through collaboration with African and Eastern European institutions, training, and evidence-based public health policy and action. Project partners focused on resistance to integrase and reverse transcriptase (RT) inhibitors, and models were developed to identify new mutations in HIV-1 and HIV-2 RT. Researchers developed the first ever web-based algorithm for HIV-2 resistance. A framework for routine HIV surveillance was developed to provide easy-to-use tools that monitor HIV transmissions using genetic sequences. This system enables the anonymous and ethnic characterisation of patients involved in particular sub-epidemics. Much of the project's work focused on improved and standardised methods for diagnostic tests as well as for data processing and analysis. This included standardised laboratory techniques and a method for rapidly estimating resistance in HIV+ patients. Further, researchers created a framework of methods to merge large data sets on HIV resistance as well as demographic and social data. CHAIN developed models of the impact of transmitted drug resistance (TDR) and HIV drug resistance. The project also conducting large-scale monitoring of TDR in Eastern Europe. Finally, the project conducted nearly 40 workshops and several courses for researchers, clinicians and policymakers across Africa and Eastern Europe. The work of CHAIN has contributed tools and data that will assist researchers and clinicians in the fight against HIV resistance.
Keywords
HIV, drug resistance, antiretroviral, real-time monitoring, public health
