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By Alexandra Sifferlin
July 20, 2017
TIME Health
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In a new report, the World Health Organization (WHO) warns that resistance to the drugs used to treat HIV is on the rise.

According to the latest WHO HIV Drug Resistance report, six out of 11 countries surveyed reported that more than 10% of people who are starting antiretroviral therapy in their country have a strain of the virus that’s resistant to the drugs used to treat it.

The countries that went above the 10% threshold are Argentina, Guatemala, Namibia, Nicaragua, Uganda and Zimbabwe. Researchers say the most rapid increase in resistant cases of HIV was observed in southern and eastern Africa. Currently the WHO recommends that countries that exceed that threshold review their treatment programs.

Drug resistance is a growing problem worldwide, though it is most commonly associated with the antibiotics used to treat bacterial infections. Drug-resistant HIV happens when there are changes to the genetic structure of HIV. Mutations in HIV strains are common, but sometimes a mutation can give the virus an advantage over antiretroviral therapies. The WHO says resistance to treatment can happen in part when people do not have access to high-quality HIV treatment and care and cannot take their full regimen of medication.

“We need to ensure that people who start treatment can stay on effective treatment, to prevent the emergence of HIV drug resistance,” said Dr. Gottfried Hirnschall, director of WHO’s HIV Department and Global Hepatitis Program, in statement about the findings. “When levels of HIV drug resistance become high we recommend that countries shift to an alternative first-line therapy for those who are starting treatment.”

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The WHO estimates that there are 36.7 million people living with HIV globally, and among those people, 19.5 million had access to antiretroviral therapy in 2016. Antiretroviral therapies have helped people live substantially longer with HIV. A study in May reported that a 20 year old infected with HIV today can expect to live about 78 years, which is almost as long as people who do not have the disease.

“Antimicrobial drug resistance is a growing challenge to global health and sustainable development,” said Dr. Tedros Adhanom Ghebreyesus, the new director-general of the WHO, in a statement. “We need to proactively address the rising levels of resistance to HIV drugs if we are to achieve the global target of ending AIDS by 2030.”

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