CEDRIC-HIV: The checklist for studies on HIV drug resistance

Recently, Mbuagbaw et al.¹ published an article in The Lancet HIV outlining the rationale and intended use of CEDRIC-HIV (Checklist for studies of HIV drug resistance incidence or prevalence). Although this checklist was designed for HIV drug resistance (HIVDR) studies, its use may extend to the wider field of epidemiology and prevention healthcare, making it a valuable addition to your journal.

Research in epidemiology and health prevention has considerably evolved, underscoring the ever-increasing need for standardised reporting practice. In particular, the emergence of drug resistance in HIV, a consequence of the widespread use of antiretroviral therapy, represents a pressing concern. This resistance encompasses acquired drug resistance (ADR) and transmitted drug resistance (TDR), with pre-treatment drug resistance (PDR) observed in individuals initiating or re-initiating therapy. The implications of these diverse forms of resistance are profound, impacting both individuals and populations. There is a critical need for standardised surveillance in resource-limited settings.^2,3

Epidemiological and preventive measures, including national and regional genotyping surveillance for infectious diseases such as HIV drug resistance (HIVDR),³ play a critical role in effectively managing this class of disease. This is especially relevant in situations where individual testing is limited due to cost and availability constraints. The data generated through these surveillance mechanisms inform decision-makers, guiding them in devising the most suitable strategies for healthcare and public health interventions.

However, the effectiveness of these strategies relies on the correct reporting of data. As highlighted by Mbuagbaw et al.,⁴ research within the field of HIV drug resistance often falls short in reporting essential information, with an average of just 13 out of 23 pertinent items being included in research reports. To address these gaps, CEDRIC-HIV was developed through rigorous phases, including surveys and expert discussions. The outcome is a comprehensive reporting checklist that makes use of 15 essential items, supported by clear explanations and practical examples to empower researchers to effectively report their studies.¹

The significance of CEDRIC-HIV extends to the improvement of the methodological quality of research, guaranteeing both data validity and synthesis of epidemiological evidence. Inadequate reporting of research results both wastes loss of valuable resources and distorts data, impeding the replication of findings.⁵

CEDRIC-HIV was developed to help researchers to improve the quality of their reporting. Moreover, the improvements that can be obtained extend to healthcare professionals and decision-makers, enabling them to make informed choices, allocate resources judiciously, and acquire a more comprehensive understanding of emerging resistance patterns, ultimately expediting access to prevention and treatment.

We invite all researchers and practitioners involved in infectious disease research to utilize the CEDRIC-HIV reporting guidelines. We encourage you to share your suggestions and feedback to further improve this resource.

Conflicts of interest: LM, MS and JF were coauthors on the Checklist for studies of HIV drug resistance prevalence or incidence: rationale and recommended use.

References

1. Mbuagbaw L, Garcia C, Brenner B, et al. Checklist for studies of HIV drug resistance prevalence or incidence: rationale and recommended use. Lancet HIV 2023;10(10):e684-89.
2. Bertagnolio S, Jordan MR, Giron A, Inzaule S. Epidemiology of HIV drug resistance in low- and middle-income countries and WHO global strategy to monitor its emergence. Curr Opin HIV AIDS 2022;17(4):229-39.
3. WHO. Guidelines on the public health response to pretreatment HIV drug resistance. 2017. Available from: https://bit.ly/2C5GI7T
4. Mbuagbaw L, Ongolo-Zogo C, Mendoza OC, et al. Guidelines are needed for studies of pre-treatment HIV drug resistance: a methodological study. BMC Med Res Methodol 2021;21(1):76.
5. Marušić A, Campbell H. Reporting guidelines in global health research. J Glob Health 2016;6(2):020101.