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This presentation by Doris Chebo looks at the risks of the change of thinking towards pushing for treatment as soon as possible after HIV diagnosis from the point of view of current Victorian baseline HIV drug resistance profiles .
The aim of earliest possible treatment is to limit risks of disease progression and reduce HIV transmission, both very worthwhile ideals .
Levels of transmitted drug resistance mutations were reviewed looking at standard drug resistance genotyping in 1356 samples from 2011 to 2015. These included new
As expected, protease and integrate inhibitor regimes had the lowest level of potential resistance (<1%). Potential resistance to NNRTIs was higher at 4.6%.
This brings up the question of whether to start people on treatment before genotype profiles are available particularly where access is more difficult.
The study was pretty reassuring for us, in that these seem like only small number of patients had significant drug resistance to our usual ASHM recommended first line treatment regimes.