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
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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Emergence and evolution of drug resistance in the absence of viral load monitoring during 48 weeks of Combivir/Tenofovir within the DART Trial.
D. Pillay,Cissy Kityo,V. Robertson,F. Lyagoba,Daniel C. Dunn,S. Tugame,J. Hakim,Paula Munderi,C. Gilks,Pontiano Kaleebu +9 more
TL;DR: Without viral load-guided treatment switch, extensive resistance evolves over 48 weeks in those with viraemia who continue to receive 1st line CBV/TDF, which indicates this population may still benefit from two major classes of drugs.
Journal Article
A pilot study to assess the immunologic and virologic efficacy of generic nevirapine, zidovudine and lamivudine in the treatment of HIV-1 infected women with pre-exposure to single dose nevirapine or short course zidovudine and their spouses in Chitungwiza, Zimbabwe.
Lynn S. Zijenah,Gerard Kadzirange,S. Rusakanhiko,T. Kufa,N. Gonah,Ocean Tobaiwa,C. Gwanzura,David Katzenstein +7 more
TL;DR: Women showed a significantly reduced response top ART relative to men only at 16.5 weeks, however, prior exposure to SD NVP for PMTCT was no more likely to negatively influence responses to ART than use of SC AZT.
Journal ArticleDOI
The President?s Emergency Plan for AIDS Relief: indicators reporting requirements and guidelines. Indicators reference guide revised for FY2007 reporting.
Chalker J,Johnson A,Patricia Myung,David Pugatch,Brady Mf,Many P,Joseph I. Harwell,Seyler C,Adje-Toure C,Messou E,Dakoury-Dogbo N,Rouet F,Dagna Constenla,Perez-Schael I,Richard Rheingans,Antil L,Salas H,Doupe A,de Brito Am,Célia Landmann Szwarcwald,de Castilho Ea,Laserson Kf,Wells Cd,Daftary A,Padayatchi N,Padilla M,Gill B,Okie S +27 more
TL;DR: The indicators in this guidance meet the overall needs of the Emergency Plan to demonstrate progress in the fight against HIV/AIDS and are designed to provide information on all dimensions of a program in country-specific settings.
Journal ArticleDOI
Poor Efficacy and Tolerability of Stavudine, Didanosine, and Efavirenz-based Regimen in Treatment-Naive Patients in Senegal
Anna Canestri,Papa Salif Sow,Muriel Vray,Fatou Ngom,Souleymane Mboup,Coumba Toure Kane,Eric Delaporte,Mandoumé Gueye,Gilles Peytavin,Pierre Marie Girard,Roland Landman +10 more
TL;DR: These data strengthen the recently revised World Health Organization (WHO) guidelines advocating initiation of highly active antiretroviral therapy (HAART) before profound CD4 lymphocyte depletion occurs and avoiding HAART regimens containing d4T and ddI because of treatment-limiting side effects.
Journal Article
Short-term effectiveness and safety of HAART in the form of a generic fixed-dose combination of stavudine, lamivudine and nevirapine (Triviro) in HIV-1-infected adults in Zimbabwe
A.G. Duse,A. Morar,I. Landman,William J.H. Vermaak,H. Schoeman,M.J. Kruger,E.S. Janse van Rensburg,R. Luthy,S. Singh +8 more
TL;DR: To assess the effectiveness and safety of a twice-daily regimen of a generic fixed-dose combination of stavudine, lamivudine and nevirapine in a cohort of Zimbabwean HIV-1-positive adults, a prospective, open-label, one-arm study is conducted.
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