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

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dc.contributor International Union against Tuberculosis and Lung Disease, Paris, France. adharries@theunion.org
dc.creator Harries, Anthony D
dc.creator Zachariah, Rony
dc.creator van Oosterhout, Joep J
dc.creator Reid, Steven D
dc.creator Hosseinipour, Mina C
dc.creator Arendt, Vic
dc.creator Chirwa, Zengani
dc.creator Jahn, Andreas
dc.creator Schouten, Erik J
dc.creator Kamoto, Kelita
dc.date 2010-01
dc.date.accessioned 2017-01-31T07:16:25Z
dc.date.available 2017-01-31T07:16:25Z
dc.identifier Diagnosis and management of antiretroviral-therapy failure in resource-limited settings in sub-Saharan Africa: challenges and perspectives. 2010, 10 (1):60-5 Lancet Infect Dis
dc.identifier 1474-4457
dc.identifier 20129150
dc.identifier 10.1016/S1473-3099(09)70321-4
dc.identifier http://hdl.handle.net/10144/95553
dc.identifier http://fieldresearch.msf.org/msf/handle/10144/95553
dc.identifier The Lancet Infectious Diseases
dc.identifier.uri http://dspace.mediu.edu.my:8181/xmlui/handle/10144/95553
dc.description 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.
dc.language en
dc.rights Published 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.
dc.title Diagnosis and management of antiretroviral-therapy failure in resource-limited settings in sub-Saharan Africa: challenges and perspectives.


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