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High prevalence of HIV-1 drug resistance among patients on first-line antiretroviral treatment in Lomé, Togo

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TLDR
The high number of resistant strains observed in Togo shows clearly that the emergence of HIV drug resistance is of increasing concern in countries where ART is now widely used, and can compromise the long-term success of first- and second-line ART.
Abstract
With widespread use of antiretroviral (ARV) drugs in Africa, one of the major potential challenges is the risk of emergence of ARV drug-resistant HIV strains. Our objective is to evaluate the virological failure and genotypic drug-resistance mutations in patients receiving first-line highly active antiretroviral therapy (HAART) in routine clinics that use the World Health Organization public health approach to monitor antiretroviral treatment (ART) in Togo.

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Journal ArticleDOI

Rates of emergence of HIV drug resistance in resource-limited settings: a systematic review.

TL;DR: The emergence of drug resistance following access to ART in resource-limited settings resembles what was seen inresource-rich countries and highlights the need for virological monitoring for drug failure, drug resistance testing and alternative drug regimens that have proven beneficial in these resource-rich settings.
Journal ArticleDOI

The origin and molecular epidemiology of HIV

TL;DR: The genetic diversity of HIV-1 continues to increase overtime due to demographic factors such as travel and migration and frequent co/superinfections, which leads to an increasing number of drug-resistant strains, especially in resource limited countries.
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Persistent Difficulties in Switching to Second-Line ART in Sub-Saharan Africa — A Systematic Review and Meta-Analysis

TL;DR: The low incidence rate of switching to second-line ART in sub-Saharan Africa suggests that the monitoring of patients under ART is challenging and that access to second -line ART is ineffective; efforts should be made to increase access toSecond- line ART to those in need by providing monitoring tools, education and training, as well as a more convenient regimen.
References
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Antiretroviral therapy for HIV infection in adults and adolescents: recommendations for a public health approach. 2006 revision.

TL;DR: These guidelines are primarily intended for use by national and regional HIV programme managers managers of nongovernmental organizations delivering HIV care services and other policy-makers who are involved in the scaling up of comprehensive HIV care and ART in resource-limited countries.
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Mortality of HIV-1-infected patients in the first year of antiretroviral therapy: comparison between low-income and high-income countries.

TL;DR: Patients starting HAART in resource-poor settings have increased mortality rates in the first months on therapy, compared with those in developed countries, and timely diagnosis and assessment of treatment eligibility, coupled with free provision of HAART might reduce this excess mortality.
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The WHO public-health approach to antiretroviral treatment against HIV in resource-limited settings

TL;DR: A public-health approach to antiretroviral therapy (ART) to enable scaling-up access to treatment for HIV-positive people in developing countries, recognising that the western model of specialist physician management and advanced laboratory monitoring is not feasible in resource-poor settings.
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Efficacy of Antiretroviral Therapy Programs in Resource-Poor Settings: A Meta-analysis of the Published Literature

TL;DR: ART treatment programs in resource-poor settings have efficacy rates similar to those reported for developed countries, and the provision of medications free of charge to the patient is associated with a significantly increased probability of virologic suppression at months 6 and 12 of ART.
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Darunavir: pharmacokinetics and drug interactions.

TL;DR: Reports from resource-limited countries suggest that initial ART programmes are as effective as in resource-rich countries, which should limit HIV drug resistance if programme effectiveness continues during scale-up.
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