Journal of Infectious Diseases
Volume 211 Issue 8 April 15, 2015
http://jid.oxfordjournals.org/content/current

Weighing the Risk of Drug Resistance With the Benefits of HIV Preexposure Prophylaxis
Robert M. Grant1,2,3 and Teri Liegler2
Author Affiliations
1Gladstone Institutes
2University of California–San Francisco
3San Francisco AIDS Foundation, California
(See the major article by Lehman et al on pages 1211–8.)
Extract
The threat of drug resistance deserves careful attention from clinicians and public health officials advocating antiretroviral use as a way to control the human immunodeficiency virus (HIV) epidemic. Such antiretroviral use includes early treatment and preexposure prophylaxis (PrEP) and postexposure prophylaxis (PEP). Concerns about drug resistance were raised before rolling out widespread antiretroviral therapy in Africa, based on the assumption that adherence to therapy would be poor and drug resistance would become prevalent. Defying expectations, the benefits of antiretroviral therapy for improving health, averting death, and preventing transmission were subsequently proven to outweigh the risks of drug resistance, and adherence to therapy in African populations is often outstanding [1]…