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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Towards an improved investment approach for an effective response to HIV/AIDS
Bernhard Schwartländer,John Stover,Timothy B. Hallett,Rifat Atun,Rifat Atun,Carlos Avila,Eleanor Gouws,Michael Bartos,Peter D. Ghys,Marjorie Opuni,David A Barr,Ramzi Alsallaq,Lori Bollinger,Marcelo de Freitas,Geoffrey P. Garnett,Charles B. Holmes,Ken E. Legins,Yogan Pillay,Anderson Stanciole,Craig McClure,Gottfried Hirnschall,Marie Laga,Nancy Padian +22 more
TL;DR: A strategic investment framework is proposed that is intended to support better management of national and international HIV/AIDS responses than exists with the present system and would avert 12·2 million new HIV infections and 7·4 million deaths from AIDS between 2011 and 2020.
Journal ArticleDOI
HIV-1 remission following CCR5Δ32/Δ32 haematopoietic stem-cell transplantation
Ravindra K. Gupta,Sultan Abdul-Jawad,Laura E. McCoy,Hoi Ping Mok,Dimitra Peppa,Maria Salgado,Javier Martinez-Picado,Javier Martinez-Picado,Monique Nijhuis,Annemarie M. J. Wensing,Helen Lee,Paul Grant,Eleni Nastouli,Jonathan Lambert,M Pace,Fanny Salasc,Christopher Monit,Andrew J. Innes,Andrew J. Innes,Luke Muir,Laura Waters,John Frater,Andrew M. L. Lever,Andrew M. L. Lever,Simon Edwards,Ian H Gabriel,Ian H Gabriel,Eduardo Olavarria,Eduardo Olavarria +28 more
TL;DR: It is suggested that a single allogeneic HSCT with homozygous CCR5Δ32 donor cells may be sufficient to achieve HIV-1 remission with reduced intensity conditioning and no irradiation, and the findings provide further support for the development of HIV- 1 remission strategies based on preventing CCR 5 expression.
Journal ArticleDOI
HIV treatment as prevention: Systematic comparison of mathematical models of the potential impact of antiretroviral therapy on HIV incidence in South Africa
Jeffrey W. Eaton,Leigh F. Johnson,Joshua A. Salomon,Till Bärnighausen,Till Bärnighausen,Eran Bendavid,Anna Bershteyn,David E. Bloom,Valentina Cambiano,Christophe Fraser,Jan A. C. Hontelez,Salal Humair,Salal Humair,Daniel J. Klein,Elisa F Long,Andrew N. Phillips,Carel Pretorius,John Stover,Edward Allen Wenger,Brian G. Williams,Timothy B. Hallett +20 more
TL;DR: In this article, the authors compared the predictions of several mathematical models simulating the same ART intervention programmes to determine the extent to which models agree about the epidemiological impact of expanded ART.
Journal ArticleDOI
Global trends in antiretroviral resistance in treatment-naive individuals with HIV after rollout of antiretroviral treatment in resource-limited settings: a global collaborative study and meta-regression analysis
Ravindra K. Gupta,Michael R. Jordan,Binta Sultan,Andrew Hill,Daniel Davis,John Gregson,Anthony W. Sawyer,Raph L. Hamers,Nicaise Ndembi,Deenan Pillay,Silvia Bertagnolio +10 more
TL;DR: A significant increase in prevalence of drug resistance over time since antiretroviral rollout in regions of sub-Saharan Africa is suggested; this rise is driven by NNRTI resistance in studies from east and southern Africa.
Journal ArticleDOI
Can the UNAIDS 90-90-90 target be achieved? A systematic analysis of national HIV treatment cascades.
TL;DR: Diosis was the greatest break point globally, but the most frequent key break point for individual countries was providing ART to those diagnosed, and large disparities were identified between countries.
References
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Journal ArticleDOI
Management of HIV-1 infection with a combination of nevirapine, stavudine, and lamivudine: a preliminary report on the Nigerian antiretroviral program.
E O Idigbe,Taiwo A Adewole,Geoffrey Eisen,Phyllis J. Kanki,Nkiru Odunukwe,Dan I Onwujekwe,Rosemary A. Audu,Idowu D Araoyinbo,Joseph I. Onyewuche,Oluwamuyiwa B Salu,John A Adedoyin,Adesola Z. Musa +11 more
TL;DR: The overall results within the 12-month treatment period indicated an effective suppression of viral replication, the reconstitution of the immune system, and improvement of the physical well-being of the study population.
Journal ArticleDOI
Low levels of antiretroviral-resistant HIV infection in a routine clinic in Cameroon that uses the World Health Organization (WHO) public health approach to monitor antiretroviral treatment and adequacy with the WHO recommendation for second-line treatment.
Charles Kouanfack,Celine Montavon,Christian Laurent,Avelin F. Aghokeng,Alain Kenfack,Anke Bourgeois,Sinata Koulla-Shiro,Eitel Mpoudi-Ngole,Martine Peeters,Eric Delaporte +9 more
TL;DR: A cross-sectional study showed low rates of virological failure and drug resistance at 12 and 24 months after initiation of antiretroviral therapy, and showed that the World Health Organization recommendation for second-line treatment would be effective in almost all patients with HIV drug resistance mutations.
Journal ArticleDOI
Rapid accumulation of nonnucleoside reverse transcriptase inhibitor-associated resistance: evidence of transmitted resistance in rural South Africa.
Roos E. Barth,Annemarie M. J. Wensing,Hugo A. Tempelman,Robert Moraba,Rob Schuurman,Andy I. M. Hoepelman +5 more
TL;DR: It appeared that several patients had drug-associated mutations prior to starting antiretrovirals, suggesting that transmission of resistance may have contributed to the accumulation of nonnucleoside reverse transcriptase inhibitor-mutations.
Journal ArticleDOI
Effectiveness of highly active antiretroviral therapy administered by general practitioners in rural South Africa.
Roos E. Barth,J. T. M. van der Meer,Andy I.M. Hoepelman,P. A. Schrooders,D.A.M.C. van de Vijver,Sibyl P. M. Geelen,H. A. Tempelman +6 more
TL;DR: This study shows that adequately monitored HIV/acquired immunodeficiency syndrome (AIDS) care administered by general practitioners and their staff is feasible and leads to good results in a rural, primary care center in sub-Saharan Africa.
Journal ArticleDOI
Evaluating Adherence to Highly Active Antiretroviral Therapy with Use of Pill Counts and Viral Load Measurement in the Drug Resources Enhancement against AIDS and Malnutrition Program in Mozambique
Massimo Magnano San Lio,Riccardo Carbini,P Germano,Giovanni Guidotti,Sandro Mancinelli,Noorjehan Abdul Magid,Pasquale Narciso,Leonardo Palombi,Elsa Renzi,Ines Zimba,Maria Cristina Marazzi +10 more
TL;DR: Treatment adherence >95% maximizes the results of the nonnucleoside reverse-transcriptase inhibitor-based regimen and the pill count method appears to be a reliable and economic tool for monitoring treatment adherence in resource-limited settings.
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