Doravirine-associated resistance mutations in antiretroviral therapy naïve and experienced adults with HIV-1 subtype C infection in Botswana

J Glob Antimicrob Resist

This study investigated how common HIV mutations related to Doravirine resistance are in HIV-1 subtype C-infected adults in Botswana. HIV-1 subtype C is one of the most prevalent strains of the virus, especially in Southern Africa. Doravirine is a medication that helps control HIV infection and stops the virus from multiplying and spreading in the body.

The researchers aimed to understand if there were any specific genetic changes in the virus that could reduce doravirine’s effectiveness or cause the drug to become less potent over time. To do this, they studied two groups of participants: those who have never taken any type of antiretroviral therapy (antiretroviral therapy naïve) and those who had previously been treated with other antiretrovirals (ART-experienced).

The findings revealed that some participants in both groups developed specific genetic mutations in the HIV virus, which were associated with resistance to doravirine. This means that in some cases, doravirine might not work as effectively as intended due to these changes in the virus.

The emergence of these resistance mutations is concerning because it could limit treatment options for HIV-1 subtype C-infected individuals in Botswana. To effectively manage HIV, it is crucial to have a range of effective antiretrovirals available, especially as the virus can evolve and become resistant to certain drugs over time.

The results of this study highlight the importance of continuously monitoring HIV drug resistance before starting doravirine-based treatment. Further research is needed to develop new treatment strategies and antiretroviral drugs that can combat the emergence of drug resistance in HIV-1 subtype C infections, ensuring that people living with HIV have access to effective and sustainable treatment options.

SANTHE is an Africa Health Research Institute (AHRI) flagship programme funded by the Science for Africa Foundation through the DELTAS Africa programme; the Bill & Melinda Gates Foundation; Gilead Sciences Inc.; and the Ragon Institute of Mass General, MIT, and Harvard.