Diagnosis and management of antiretroviral-therapy failure in resource-limited settings in sub-Saharan Africa: challenges and perspectives.

Hdl Handle:
http://hdl.handle.net/10144/95553
Title:
Diagnosis and management of antiretroviral-therapy failure in resource-limited settings in sub-Saharan Africa: challenges and perspectives.
Authors:
Harries, Anthony D; Zachariah, Rony; van Oosterhout, Joep J; Reid, Steven D; Hosseinipour, Mina C; Arendt, Vic; Chirwa, Zengani; Jahn, Andreas; Schouten, Erik J; Kamoto, Kelita
Journal:
The Lancet Infectious Diseases
Abstract:
Despite the enormous progress made in scaling up antiretroviral therapy (ART) in sub-Saharan Africa, many challenges remain, not least of which are the identification and management of patients who have failed first-line therapy. Less than 3% of patients are receiving second-line treatment at present, whereas 15-25% of patients have detectable viral loads 12 months or more into treatment, of whom a substantial proportion might have virological failure. We discuss the reasons why virological ART failure is likely to be under-diagnosed in the routine health system, and address the current difficulties with standard recommended second-line ART regimens. The development of new diagnostic tools for ART failure, in particular a point-of-care HIV viral-load test, combined with simple and inexpensive second-line therapy, such as boosted protease-inhibitor monotherapy, could revolutionise the management of ART failure in resource-limited settings.
Affiliation:
International Union against Tuberculosis and Lung Disease, Paris, France. adharries@theunion.org
Issue Date:
Jan-2010
URI:
http://hdl.handle.net/10144/95553
DOI:
10.1016/S1473-3099(09)70321-4
PubMed ID:
20129150
Language:
en
ISSN:
1474-4457
Appears in Collections:
HIV/AIDS

Full metadata record

DC FieldValue Language
dc.contributor.authorHarries, Anthony Den
dc.contributor.authorZachariah, Ronyen
dc.contributor.authorvan Oosterhout, Joep Jen
dc.contributor.authorReid, Steven Den
dc.contributor.authorHosseinipour, Mina Cen
dc.contributor.authorArendt, Vicen
dc.contributor.authorChirwa, Zenganien
dc.contributor.authorJahn, Andreasen
dc.contributor.authorSchouten, Erik Jen
dc.contributor.authorKamoto, Kelitaen
dc.date.accessioned2010-04-05T19:31:07Z-
dc.date.available2010-04-05T19:31:07Z-
dc.date.issued2010-01-
dc.identifier.citationDiagnosis and management of antiretroviral-therapy failure in resource-limited settings in sub-Saharan Africa: challenges and perspectives. 2010, 10 (1):60-5 Lancet Infect Disen
dc.identifier.issn1474-4457-
dc.identifier.pmid20129150-
dc.identifier.doi10.1016/S1473-3099(09)70321-4-
dc.identifier.urihttp://hdl.handle.net/10144/95553-
dc.description.abstractDespite the enormous progress made in scaling up antiretroviral therapy (ART) in sub-Saharan Africa, many challenges remain, not least of which are the identification and management of patients who have failed first-line therapy. Less than 3% of patients are receiving second-line treatment at present, whereas 15-25% of patients have detectable viral loads 12 months or more into treatment, of whom a substantial proportion might have virological failure. We discuss the reasons why virological ART failure is likely to be under-diagnosed in the routine health system, and address the current difficulties with standard recommended second-line ART regimens. The development of new diagnostic tools for ART failure, in particular a point-of-care HIV viral-load test, combined with simple and inexpensive second-line therapy, such as boosted protease-inhibitor monotherapy, could revolutionise the management of ART failure in resource-limited settings.en
dc.language.isoenen
dc.rightsPublished by Elsevier Reproduced on this site with permission of Elsevier Ltd. Please see [url]http://www.thelancet.com/journals/laninf[/url] for further relevant comment.en
dc.subject.meshAfrica South of the Saharaen
dc.subject.meshAnti-HIV Agentsen
dc.subject.meshHIV Infectionsen
dc.subject.meshHealth Care Costsen
dc.subject.meshHumansen
dc.subject.meshRNA, Viralen
dc.subject.meshTreatment Failureen
dc.subject.meshViral Loaden
dc.titleDiagnosis and management of antiretroviral-therapy failure in resource-limited settings in sub-Saharan Africa: challenges and perspectives.en
dc.contributor.departmentInternational Union against Tuberculosis and Lung Disease, Paris, France. adharries@theunion.orgen
dc.identifier.journalThe Lancet Infectious Diseasesen

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