WELCOME TO THE INTERNATIONAL WORKSHOP ON HIV DRUG RESISTANCE AND TREATMENT STRATEGIES

Spanning 31 years of research in antiretroviral drug resistance, the International Workshop on HIV Drug Resistance and Treatment Strategies has focussed on clinical trial findings, treatment strategies, sequencing, case reports, programmatic recommendations, surveillance and epidemiology, and laboratory science. As treatment options in high-income settings have allowed for optimised and personalised approaches to HIV management, the workshop has directed its focus in the past 7 years to the development of antiretroviral resistance in low-to-middle income settings, where population-based approaches to HIV treatment and management are more common.

The 2023 workshop – held in Cape Town on 20 to 22 September 2023, primarily focussed on resistance to the integrase strand transfer inhibitors dolutegravir (DTG) and cabotegravir (CAB). As the switch from TEE to TLD is well underway in many LMIC countries, the conference received a range of abstracts reporting DTG resistance patterns, profiles, and proportions in unsuppressed adult and paediatric populations. Abstracts presented included reports from South Africa, Uganda, Mozambique, Malawi, Nigeria, Tanzania, Zimbabwe, Haiti, Cuba, Togo, and Cameroon. Overall, these finding cautioned that while resistance to dolutegravir remains rare, rates of detection are increasing over time and TLD scale-up, and that levels of resistance to DTG needs to be closely monitored and controlled to ensure sustained efficacy of these regimens for many years.

Resistance to cabotegravir, provided either as PrEP or prophylaxis, and either as oral or injection formulation, was also discussed, following the recent licensing of injectable CAB-LA formulations. Much of the available data is derived from clinical trials, and notably covered in plenary lectures by Jean Nachega, Monica Gandhi, Linda-Gail Bekker and Urvi Parikh. Recent case-reports of rapid CAB/RPV injection failure were presented from USA, South Africa and the Netherlands. Vigorous interactive discussions added to the value of the meeting, especially regarding the issue of the benefits and challenges of the introduction of long acting antiretroviral drugs for treatment and prevention in LMIC.

As a last mention, we were very fortunate to have a presentation from Karol Serwin showcasing how phylodynamic mapping can track the migration of HIV-1 from Ukraine into Poland as a result of the Russian invasion!

Many of the presentations and posters are available on this website as well as the conference programme.

Save the Dates for the 31st International Workshop on HIV Drug Resistance and Treatment Strategies: 2 to 4 September 2025 at Lord Charles Hotel, Cape Town, South Africa.