Journal ArticleDOI
Virological follow-up of adult patients in antiretroviral treatment programmes in sub-Saharan Africa: a systematic review
Roos E. Barth,Maarten F. Schim van der Loeff,Rob Schuurman,Andy I.M. Hoepelman,Annemarie M. J. Wensing +4 more
TLDR
Profiles of drug resistance suggest that a second-line treatment regimen based on protease inhibitors, with a backbone of nucleoside reverse transcriptase inhibitor, is a reasonable option for patients with HIV in sub-Saharan Africa who experience first- line treatment failure.Abstract:
Following large-scale roll-out of antiretroviral therapy in sub-Saharan Africa, the non-clinical efficacy of antiretroviral therapy has received little attention. We aimed to systematically review virological efficacy and drug-resistance outcomes of programmes of antiretroviral therapy in sub-Saharan Africa. 89 studies with heterogeneous design, definitions, and methods were identified. Overall, in on-treatment analysis, 10 351 (78%) of 13 288 patients showed virological suppression after 6 months of antiretroviral therapy, 7413 (76%) of 9794 after 12 months, and 3840 (67%) of 5690 after 24 months. Long-term virological data are scarce. Genotyping results were available for patients with virological failure (HIV-1 RNA greater than 1000 copies per mL). Most patients (839 of 849; 99%) were infected with a non-B HIV-1 subtype. However, drug-resistance patterns were largely similar to those in subtype B. Resistance profiles were associated with the antiretroviral drugs commonly used: the lamivudine-associated M184V mutation was most common, followed by K103N which is associated with non-nucleoside reverse transcriptase inhibitors. Thymidine-analogue mutations and the K65R mutation were less common. First-line antiretroviral therapy regimens used in sub-Saharan Africa are effective. Profiles of drug resistance suggest that a second-line treatment regimen based on protease inhibitors, with a backbone of nucleoside reverse transcriptase inhibitors, is a reasonable option for patients with HIV in sub-Saharan Africa who experience first-line treatment failure.read more
Citations
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Journal ArticleDOI
Low primary and secondary HIV drug-resistance after 12 months of antiretroviral therapy in human immune-deficiency virus type 1 (HIV-1)-infected individuals from Kigali, Rwanda
John Rusine,Brenda Asiimwe-Kateera,Janneke van de Wijgert,Kimberly R. Boer,Enatha Mukantwali,Etienne Karita,Agnes Gasengayire,Suzanne Jurriaans,Menno de Jong,Pascale Ondoa +9 more
TL;DR: The accumulation of acquired HIVDR mutations in some participants underscores the need to reinforce HIVDR prevention strategies, such as increasing the availability and appropriate use of VL testing to monitor ART response, ensuring high quality adherence counseling, and promoting earlier identification of HIV patients and enrollment into HIV care and treatment programs.
Journal ArticleDOI
HIV-1 drug-resistance surveillance among treatment-experienced and -naïve patients after the implementation of antiretroviral therapy in Ghana.
Nicholas Israel Nii-Trebi,Shiro Ibe,Jacob Samson Barnor,Koichi Ishikawa,James Brandful,Sampson Badu Ofori,Shoji Yamaoka,William Ampofo,Wataru Sugiura +8 more
TL;DR: Despite expanding accessibility to ART in Eastern Ghana, the prevalence of transmitted HIV-1 drug resistance presently appears to be low, and careful monitoring of transmitted virus resistance is necessary.
Journal ArticleDOI
Separation of Plasma from Whole Blood by Use of the cobas Plasma Separation Card: a Compelling Alternative to Dried Blood Spots for Quantification of HIV-1 Viral Load.
Sergio Carmona,Sergio Carmona,Britta Seiverth,Dieketseng Magubane,Lucia Hans,Lucia Hans,Matthias Hoppler +6 more
TL;DR: PSC samples correlate well with plasma viral load and have adequate sensitivity and specificity, and improved performance may be as a result of a reduction in contribution from cell-associated viral nucleic acids.
Journal ArticleDOI
HIV prevention counseling intervention delivered during routine clinical care reduces HIV risk behavior in HIV-infected South Africans receiving antiretroviral therapy: the Izindlela Zokuphila/Options for Health randomized trial.
Jeffrey D. Fisher,Deborah H. Cornman,Paul A. Shuper,Paul A. Shuper,Sarah Christie,Sandy Pillay,Susan MacDonald,Ntombenhle Ngcobo,K. Rivet Amico,Umesh G. Lalloo,Gerald Friedland,William A. Fisher +11 more
TL;DR: Effective behavioral interventions, delivered by lay counselors within the clinical care setting, are consistent with the strategy of linking HIV care and HIV prevention and integrating biomedical and behavioral approaches to stemming the HIV epidemic.
Journal ArticleDOI
The risk of HIV drug resistance following implementation of pre-exposure prophylaxis.
TL;DR: Results of trials determining if pre-exposure prophylaxis with antiretroviral drugs prevents transmission of HIV are expected soon, and Mathematical modeling suggests that, although transmitted drug resistance may under some circumstances increase, the benefits of PrEP outweigh the risks associated with resistance.
References
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Journal ArticleDOI
Improving the quality of reports of meta-analyses of randomised controlled trials: the QUOROM statement
TL;DR: This report hopes this report will generate further thought about ways to improve the quality of reports of meta-analyses of RCTs and that interested readers, reviewers, researchers, and editors will use the QUOROM statement and generate ideas for its improvement.
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Efavirenz plus Zidovudine and Lamivudine, Efavirenz plus Indinavir, and Indinavir plus Zidovudine and Lamivudine in the Treatment of HIV-1 Infection in Adults
Schlomo Staszewski,Javier O Morales-Ramirez,Karen T. Tashima,Anita Rachlis,Daniel J. Skiest,James F. Stanford,Richard Stryker,Philip J. Johnson,Dominic F. Labriola,Dianne Farina,Douglas J. Manion,Nancy M. Ruiz +11 more
TL;DR: As antiretroviral therapy in HIV-1-infected adults, the combination of efavirenz, zidovudine, and lamivudine has greater antiviral activity and is better tolerated than the combination.
Journal ArticleDOI
Patient Retention in Antiretroviral Therapy Programs in Sub-Saharan Africa: A Systematic Review
TL;DR: Better patient tracing procedures, better understanding of loss to follow-up, and earlier initiation of ART to reduce mortality are needed if retention in ART programs in sub-Saharan Africa is to be improved.
Journal ArticleDOI
Class-Sparing Regimens for Initial Treatment of HIV-1 Infection
Sharon A. Riddler,Richard Haubrich,A. Gregory DiRienzo,Lynne Peeples,William G. Powderly,Karin L. Klingman,Kevin W. Garren,Tania George,James F. Rooney,Barbara Brizz,Umesh G. Lalloo,Robert L. Murphy,Susan Swindells,Diane V. Havlir,John W. Mellors +14 more
TL;DR: The virologic efficacy of the NRTI-sparing regimen was similar to that of the efavirenz regimen but was more likely to be associated with drug resistance.
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