• Cost and cost-effectiveness of switching from d4T or AZT to a TDF-based first-line regimen in a resource-limited setting in rural Lesotho

      Jouquet, Guillaume; Bygrave, Helen; Kranzer, Katharina; Ford, Nathan; Gadot, Laurent; Lee, Janice; Hilderbrand, Katherine; Goemaere, Eric; Vlahakis, Natalie; Trivino, Laura; Makakole, Lipontso; Cleary, Susan; Medecins Sans Frontieres, Morija, Lesotho; Department of Infectious and Tropical Diseases, Clinical Research Unit, London School of Hygiene and Tropical Medicine, UK; Medecins Sans Frontieres, Cape Town, South Africa; Centre for Infectious Disease Epidemiology and Research, University of Cape Town, South Africa; Medecins Sans Frontieres, Geneva, Switzerland; Scott Hospital, Morija, Lesotho; Health Economics Unit, University of Cape Town, South Africa (Lippincott Williams & Wilkins, 2011-11-01)
      Latest World Health Organization guidelines recommend shifting away from Stavudine (d4T)-based regimens due to severe side effects. However, widespread replacement of d4T by Tenofovir (TDF) or Zidovudine (AZT) is hampered by cost concerns.
    • Diagnosis and management of antiretroviral-therapy failure in resource-limited settings in sub-Saharan Africa: challenges and perspectives.

      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; International Union against Tuberculosis and Lung Disease, Paris, France. adharries@theunion.org (2010-01)
      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.
    • Editorial: The AIDS crisis, cost-effectiveness and academic activism.

      Boelaert, M; Van Damme, W; Meessen, B; Van der Stuyft, P (2002-12)
    • Universal access in the fight against HIV/AIDS

      Girard, Françoise; Ford, Nathan; Montaner, Julio; Cahn, Pedro; Katabira, Elly; Open Society Institute Public Health Program, New York, NY, USA; Médecins Sans Frontières, Cape Town, South Africa; Division of AIDS, University of British Columbia, Vancouver, BC, Canada; Fundacion Huesped, Buenos Aires, Argentina; Department of Research, Makerere Medical School, Kampala, Uganda. (2010-07-09)