Annual Report 2020: Resistance monitoring of viruses in Norway (RAVN)
The report, which is in English, presents Norwegian data for 2020 on resistance to drugs used in the treatment of some viral infections. These include the disease influenza, HIV-1 infection, hepatitis B virus infection, hepatitis C virus infection and herpes virus infections in humans. The report also describes the consumption of antiviral drugs in Norway.
Title: Use of antiviral drugs and the occurrence of antiviral resistance in Norway 2020
Hepatitis
In connection with the introduction of a national strategy against hepatitis in 2018, it has been desirable to establish a resistance monitoring of hepatitis C virus (HCV). This year’s report presents the first data from resistance studies of HCV in Norway which show that virus variants with resistance mutations are circulating in Norway. A system for national monitoring of people who have been newly diagnosed with the disease is imminent. Until this system is established, we will not be able to provide representative data on the incidence of resistance mutations in HCV infection in Norway.
HIV infection
With regard to the prevalence of resistant HIV in Norway, there appears to be a small increase in 2020 compared with previous years.
– We see that some people are infected with virus variants where one or two drugs will have a reduced effect, but where there are still many other good treatment options, says chief physician Anne-Marte Bakken Kran at the National Institute of Public Health. She emphasizes that there is no evidence of increased resistance to the drugs used for preventive purposes such as pre-exposure prophylaxis (PrEP) for HIV.
Other viral infections
For viral infections other than HIV and HCV, only a few isolated cases of resistance have been found. As in previous years, this has only been demonstrated in samples from patients receiving or receiving antiviral therapy, and no further infection with resistant viruses has been demonstrated.
Consumption of antiviral drugs
There has been an annual increase in the consumption of antiviral drugs in recent years, but in 2020 this increase appears to have stagnated. This may be related to a decrease in the number of people treated for hepatitis C. But it is too early to say whether this is actually due to fewer people needing treatment than before as a result of a successful national strategy against hepatitis. The increase in the use of drugs against HIV infection has also slowed down, and for both HIV and HCV there is a continued shift from drugs with an active ingredient to combination drugs.
In addition to monitoring data, this year’s RAVN report focuses on three current topics:
- How to define an antiviral drug in light of new treatment principles
- Monitoring of resistance to HIV integrase inhibitors
- Overview of antiviral treatment strategies for SARS-CoV-2 from a virological perspective