Emerging antiretroviral drug resistance in sub-Saharan Africa: novel affordable technologies are needed to provide resistance testing for individual and public health benefits

Authors

Gert U. van Zyl, Stellenbosch University
Lisa M. Frenkel, University of Washington
Michael Chung, Aga Khan UniversityFollow
Wolfgang Preiser, Stellenbosch University
John W. Mellors, Pittsburgh School of Medicine and Graduate School of Public Health
Jean B. Nachega, Stellenbosch University

Document Type

Article

Department

Internal Medicine (East Africa)

Abstract

In industrialized countries, viral load monitoring and genotypic antiretroviral drug resistance testing (GART) play an important role in the selection of initial and subsequent combination antiretroviral therapy (cART) regimens. In contrast, resource constraints in Africa limit access to assays that could detect virologic failure, transmitted drug resistance (TDR) and acquired drug resistance to cART. This has adverse consequences for both individual and public health. Although the further roll-out of antiretrovirals for prevention, including preexposure prophylaxis (PrEP) and universal test and treat (UTT) strategies, could reduce HIV-1 incidence, these strategies may increase TDR [1,2]. Here, we present arguments that the scale up of antiretrovirals use should be accompanied by cost-effective assays for early detection of virologic failure, surveillance of TDR and GART for individual patient management.

Comments

This work was published before the author joined Aga Khan University.

Publication (Name of Journal)

AIDS

Recommended Citation

van Zyl, G. U., Frenkel, L. M., Chung, M., Preiser, W., Mellors, J. W., Nachega, J. B. (2014). Emerging antiretroviral drug resistance in sub-Saharan Africa: novel affordable technologies are needed to provide resistance testing for individual and public health benefits. AIDS, 28(18), 2643-2648.
Available at: https://ecommons.aku.edu/eastafrica_fhs_mc_intern_med/61