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HIV drug resistance in low-income and middle-income countries

Abstract:
After 15 years of global scale-up of antiretroviral therapy (ART), rising prevalence of HIV drug resistance in many low-income and middle-income countries (LMICs) poses a growing threat to the HIV response, with the potential to drive an increase in mortality, HIV incidence, and costs. To achieve UNAIDS global targets, enhanced strategies are needed to improve quality of ART services and durability of available ART regimens, and to curb resistance. These strategies include roll out of drugs with greater efficacy and higher genetic barriers to resistance than those that are currently widely used, universal access to and improved effectiveness of viral load monitoring, patient-centred care delivery models, and reliable drug supply chains, in conjunction with frameworks for resistance monitoring and prevention. In this Review, we assess contemporary data on HIV drug resistance in LMICs and their implications for the HIV response, highlighting the potential impact and resistance risks of novel ART strategies and knowledge gaps.
Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1016/S2352-3018(18)30173-5

Authors

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Institution:
University of Oxford
Division:
MSD
Department:
NDM
Sub department:
Tropical Medicine
Sub unit:
OUCRU Oxford University Clinical Research Unit
Role:
Author


Publisher:
Elsevier
Journal:
Lancet HIV More from this journal
Volume:
5
Issue:
10
Pages:
E588-E596
Publication date:
2018-09-04
DOI:
ISSN:
2352-3018


Pubs id:
pubs:928869
UUID:
uuid:7950f7aa-da6b-4d0f-a7ec-d8c7f4a4e705
Local pid:
pubs:928869
Source identifiers:
928869
Deposit date:
2018-10-22
ARK identifier:

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