The Impact of HIV Drug Resistance on the Selection of First- and Second-Line ART in Resource-Limited Settings

2013 ◽  
Vol 207 (suppl 2) ◽  
pp. S45-S48 ◽  
Author(s):  
S. Bertagnolio ◽  
C. F. Perno ◽  
S. Vella ◽  
D. Pillay
Keyword(s):  
Drug Resistance ◽  
Second Line ◽  
Resource Limited Settings ◽  
Hiv Drug Resistance ◽  
Resource Limited ◽  
The Impact ◽  
Selection Of

scholarly journals Emergence of HIV Drug Resistance During First- and Second-Line Antiretroviral Therapy in Resource-Limited Settings

2013 ◽  
Vol 207 (suppl_2) ◽  
pp. S49-S56 ◽  
Author(s):  
Mina C. Hosseinipour ◽  
Ravindra K Gupta ◽  
Gert Van Zyl ◽  
Joseph J. Eron ◽  
Jean B. Nachega
Keyword(s):  
Drug Resistance ◽  
Antiretroviral Therapy ◽  
Second Line ◽  
Resource Limited Settings ◽  
Hiv Drug Resistance ◽  
Resource Limited ◽  
Second Line Antiretroviral Therapy

scholarly journals HIV drug resistance surveillance for prioritizing treatment in resource-limited settings

AIDS ◽  
2007 ◽  
Vol 21 (8) ◽  
pp. 973-982 ◽  
Author(s):  
Rochelle P Walensky ◽  
Milton C Weinstein ◽  
Yazdan Yazdanpanah ◽  
Elena Losina ◽  
Lauren M Mercincavage ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Resource Limited Settings ◽  
Hiv Drug Resistance ◽  
Resource Limited

scholarly journals Prevalence and Correlates of Pre-Treatment HIV Drug Resistance among HIV-Infected Children in Ethiopia

Viruses ◽  
2019 ◽  
Vol 11 (9) ◽  
pp. 877 ◽  
Author(s):  
Birkneh Tilahun Tadesse ◽  
Olivia Tsai ◽  
Adugna Chala ◽  
Tolossa Eticha Chaka ◽  
Temesgen Eromo ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Reverse Transcriptase ◽  
Hiv Treatment ◽  
Hiv Care ◽  
Virologic Suppression ◽  
Reverse Transcriptase Inhibitors ◽  
Resource Limited Settings ◽  
Nucleoside Reverse Transcriptase Inhibitors ◽  
Hiv Drug Resistance ◽  
Resource Limited

Pediatric human immunodeficiency virus (HIV) care in resource-limited settings remains a major challenge to achieving global HIV treatment and virologic suppression targets, in part because the administration of combination antiretroviral therapies (cART) is inherently complex in this population and because viral load and drug resistance genotyping are not routinely available in these settings. Children may also be at elevated risk of transmission of drug-resistant HIV as a result of suboptimal antiretroviral administration for prevention of mother-to-child transmission. We investigated the prevalence and the correlates of pretreatment HIV drug resistance (PDR) among HIV-infected, cART-naive children in Ethiopia. We observed an overall PDR rate of 14%, where all cases featured resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs): ~9% of participants harbored resistance solely to NNRTIs while ~5% harbored resistance to both NNRTIs and nucleoside reverse transcriptase inhibitors (NRTIs). No resistance to protease inhibitors was observed. No sociodemographic or clinical parameters were significantly associated with PDR, though limited statistical power is noted. The relatively high (14%) rate of NNRTI resistance in cART-naive children supports the use of non-NNRTI-based regimens in first-line pediatric treatment in Ethiopia and underscores the urgent need for access to additional antiretroviral classes in resource-limited settings.

scholarly journals Utilization of dried blood spot specimens can expedite nationwide surveillance of HIV drug resistance in resource-limited settings

PLoS ONE ◽  
2018 ◽  
Vol 13 (9) ◽  
pp. e0203296 ◽  
Author(s):  
Guoqing Zhang ◽  
Joshua DeVos ◽  
Sandra Medina-Moreno ◽  
Nicholas Wagar ◽  
Karidia Diallo ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Dried Blood Spot ◽  
Resource Limited Settings ◽  
Hiv Drug Resistance ◽  
Resource Limited ◽  
Nationwide Surveillance ◽  
Blood Spot

scholarly journals A Multi-Disciplinary Care Model for People with Drug-Resistant HIV: The AMPATH HIV Drug Resistance Clinic in Kenya

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Bilal Jawed ◽  
John Humphery ◽  
Adrian Gardner
Keyword(s):  
Drug Resistance ◽  
Hiv Care ◽  
People Living With Hiv ◽  
Drug Resistant ◽  
Second Line ◽  
Care Model ◽  
Patient Centered ◽  
Hiv Drug Resistance ◽  
Viral Loads ◽  
Resource Limited

Background: HIV mortality has decreased with the availability of ART (antiretroviral therapy) in resource-limited settings, resulting in an increase in the number of people living with HIV (PLHIV) globally. This increase in PLHIV has shifted the HIV-care model from an acute to a chronic approach requiring more effort to combat barriers to viral suppression such as long-term adherence to ART, stigma, and drug resistance. An increasing number of PLHIV are failing “2nd line” protease-inhibitor based ART as a result of these barriers, leaving these patients with limited options for treatment. To address this issue, the Academic Model Providing Access to Healthcare (AMPATH) created a multidisciplinary HIV-drug resistance clinic focusing on supporting patients failing second-line ART in 2015. The objective of this study is to describe the implementation of the AMPATH DRC in western Kenya. Methods: The HIV Drug Resistance Clinic (DRC) accepts patients from over 20 surrounding HIV clinics in a setting with over 100,000 PLHIV. The DRC identifies and enrolls patients failing second-line ART defined as ≥ 2 viral loads ≥ 1,000 copies/mL despite adherence interventions. The multidisciplinary team consists of HIV-specialist physicians, trained HIV-peer counselors, clinical pharmacists, and social workers who collaborate with patients in clinic to identify barriers to adherence and implement patient-centered interventions to mitigate barriers to adherence, treat drug resistance, and maximize the efficacy of ART. The DRC staff has expertise in ART regimen selection for patients with advance HIV drug resistance through analysis of drug resistant test results (i.e. HIV genotype). Over 600 patients have received care at the DRC since 2015. Personal role: Identifying barriers and facilitators to implementation of DRCs in regional AMPATH sites, data abstraction to determine DRC clinical outcomes, and introduction of DRT results in the AMPATH MRS. Moving Forward: By building the capacity of clinical leaders in decentralized regional AMPATH sites, we hope to expand the DRC care model within the AMPATH network. 

Sign in / Sign up

Export Citation Format

Share Document