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

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

Nationwide Estimates of Viral Load Suppression and Acquired HIV Drug Resistance in Cameroon.

TL;DR: Results of this first nationwide study indicate alarming levels of virological failure and ADR in Cameroon and better ART management is urgently needed and should focus on improving ART adherence, availability of VL monitoring, and more timely switches to second-line ART.
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Prevalence of HIV-1 drug resistance among patients failing first-line ART in Monrovia, Liberia: a cross-sectional study

TL;DR: The high prevalence of acquired drug resistance in patients followed in two centres of the Liberian capital city, documented after a median of 3 years on a first-line ART regimen, jeopardizes the activity of second-line regimens and highlights the need for virological monitoring in these settings.

HIV, Biomedical Prevention, and the Performativity of the Law

Kane Race
TL;DR: In this article, the authors consider the operation of various framing devices that attribute responsibility and causation with regard to HIV events and propose that we need to sharp-en our analytic focus on what these devices do, their performativity, their full range of societal impli- cations and effects.
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Spatiotemporal dynamics of the HIV-1 CRF06_cpx epidemic in Western Africa.

TL;DR: The CRF06_cpx epidemic in western Africa probably emerged at the late 1970s and grew during the 1980s at a rate comparable to the HIV-1 epidemics in the United States and Europe.
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Antiretroviral Resistance After First-Line Antiretroviral Therapy Failure in Diverse HIV-1 Subtypes in the SECOND-LINE Study.

TL;DR: In this paper, the authors investigate mutations and correlates according to HIV-1 subtype after virological failure (VF) of standard first-line antiretroviral therapy (ART) (non-nucleoside/nucleotide reverse transcriptase inhibitor [NNRTI] +2 nucleoside or nucleotide Reverse transcriptase inhibitors [N(t)RTI]).
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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