Accurate and cost-effective test of HIV drug resistance

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TraversA team from the University of the Western Cape (UWC) has created a world-class programme which will rapidly, accurately and cost-effectively test HIV drug resistance. The development of the programme, called Exatype, is in response to statistics which show that of the 3.1m South Africans currently on ARV treatment, almost 10% do not respond adequately to the first-line drugs provided to them, the South African Medical Research Council (SAMRC) said in a IoL report.

The DNA of the HI virus is sequenced using next-generation sequencing (NGS) technology and the results uploaded to a web-based system. The data is analysed using Exatype to quickly and accurately produce an easy-to-interpret report showing the clinician which drugs would be most effective for that individual patient at that time.

The report says the technology, developed over five years by Professor Simon Travers and his team of researchers based at the South African National Bioinformatics Institute (Sanbi) at UWC, has been tested in collaboration with a number of researchers and laboratories in South Africa and is being further developed.

Although initially focusing on HIV drug resistance testing, solutions for TB and antibiotic resistance testing are also being developed, Travers said.

According to the World Health Organisation, HIV has the ability to mutate and reproduce itself in the presence of antiretroviral drugs. The consequences of this include treatment failure, a need to start more costly second- and third-line treatments, increased health costs associated with these, and the spread of drug-resistant HIV.

In South Africa, Travers said, drug-resistant testing was not done routinely. Whereas in a country like the US resistant tests were regularly done from diagnosis, before treatment and in the case of treatment failing. In South Africa, drug resistance tests will be done only after a patient has failed the second set of treatment, Travers said.

Travers added that another problem Exatype solved was dealing with complicated information. “The data in general is difficult to understand and so people have started to look at these types of approaches. We developed a programme to make it easier to test drug-resistant HIV,” he said. “Drug resistance is not a major problem at the moment, but down the line it could become one, so we are creating a solution now to that problem.”

Exatype is currently web-based, but the report quoted Travers as saying that the group was looking to have the programme made available for the public health sector.

“We are delighted to have been a part of this programme and to demonstrate that South African innovation can indeed be used to address local health priorities,” SAMRC director of grants, innovation and product development Dr Richard Gordon said.

The Department of Science and Technology, through the SAMRC, is funding medical innovations like Exatype to improve the ability of clinicians to diagnose HIV drug-resistant patients, the report said.

Full IoL report
MRC statement

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