Pretreatment HIV drug resistance (PDR) is increasing in sub-Saharan Africa, driven by increasing resistance to non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs. This has led WHO to recommend that countries with a population prevalence of NNRTIs resistance greater than 10% adopt alternative first-line regimens, or consider PDR testing to guide selection of antiretroviral therapy (ART). ^,  In response, many countries in sub-Saharan Africa are now rolling out dolutegravir-based first-line ART. These recommendations rely on the theoretical basis that efavirenz efficacy is significantly curtailed in the presence of NNRTI resistance and that drug resistance testing before initiation of efavirenz-based ART enables selection of more efficacious regimens.

中文翻译：

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对一线HIV药物治疗方案的循环耐药性。

在撒哈拉以南非洲，由于对非核苷类逆转录酶抑制剂（NNRTI）药物的耐药性增加，预处理HIV药物耐药性（PDR）不断增加。因此，世卫组织建议对NNRTIs耐药率高于10％的国家采用替代的一线治疗方案，或考虑进行PDR检测以指导抗逆转录病毒疗法（ART）的选择。^， 对此，许多国家在撒哈拉以南非洲地区正在推出基于dolutegravir-一线ART。这些建议基于以下理论基础：在存在NNRTI耐药性的情况下，依非韦伦的疗效显着降低，并且在基于依非韦伦的抗逆转录病毒治疗开始之前进行耐药性测试可以选择更有效的治疗方案。