TY - JOUR T1 - Bedaquiline resistance in drug-resistant tuberculosis HIV co-infected patients JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.02383-2019 VL - 55 IS - 6 SP - 1902383 AU - Camus Nimmo AU - James Millard AU - Kayleen Brien AU - Sashen Moodley AU - Lucy van Dorp AU - Keeren Lutchminarain AU - Allison Wolf AU - Alison D. Grant AU - Francois Balloux AU - Alexander S. Pym AU - Nesri Padayatchi AU - Max O'Donnell Y1 - 2020/06/01 UR - http://erj.ersjournals.com/content/55/6/1902383.abstract N2 - Global tuberculosis (TB) control is threatened by drug resistance, with over 500 000 cases resistant to first-line drugs in 2018 [1]. Bedaquiline is a highly effective TB drug and has improved drug-resistant TB (DR-TB) outcomes in trial and programmatic settings [2, 3]. The World Health Organization (WHO) recommends its inclusion in most DR-TB regimens [4] and it is under further evaluation in clinical trials. There have been several reports of clinical bedaquiline resistance [5–8]. Resistance-associated variants (RAVs) in clinical isolates identified to date are almost exclusively caused by Rv0678 mutations which can raise Mycobacterium tuberculosis minimum inhibitory concentrations (MICs) for bedaquiline and clofazimine [9].Genetic mutations linked to bedaquiline resistance were found before starting treatment and acquired during treatment in patients with drug-resistant TB and HIV in KwaZulu-Natal, South Africa. Routine bedaquiline resistance testing needs to be accelerated. http://bit.ly/2vnL4VY ER -