A major review of HIV-1 in Ghana has warned that the country needs stronger tracking of drug resistance as treatment expands.
The review covered 20 years of data, from 2004 to 2024. Researchers screened 2,472 studies, reviewed 28 in full and included 18 in the final analysis.
The combined sample covered 2,001 people living with HIV-1 in Ghana.
The most common HIV-1 subtype was CRF02_AG, which made up 68.9% of cases. Other recombinant forms made up 16.8%. Subtype G accounted for 3.5%, while other individual subtypes were much smaller.
The review also found important drug resistance mutations. For NRTI drugs, M184V/I was detected at 41.2%. For NNRTI drugs, K103N appeared in 28.4% of cases.
For protease inhibitor resistance, M46I/L was reported at 25.0%.
The concern is that only 2 studies looked at integrase gene resistance mutations. This is important because modern HIV treatment often depends on integrase inhibitors.
The public message is not that HIV treatment is failing. It is that Ghana needs better routine surveillance to protect treatment success.
As more people stay on antiretroviral therapy for many years, the country must keep watching the virus closely.