Resistance considerations in sequencing of antiretroviral therapy in low-middle income countries with currently available options

Andrea De Luca, Mattia Prosperi, Laura Bracciale

    Research output: Contribution to journalArticlepeer-review

    Abstract

    Purpose of review: Access to antiretroviral therapy (ART) has been scaled-up in low-middle income countries (LMICs), where the majority of the world's HIV-1-infected population is living. Concerns towards the emergence and spread of HIV-1 drug resistance exist, given the lack of virological monitoring which may give rise to accumulation of resistance as well as the use of suboptimal ART in pregnant women with the aim to reduce perinatal transmission. Knowledge of the prevalence of transmitted and emerging drug resistance as well as its specific patterns is of help in guiding the selection of appropriate ART types and sequencing strategies. Recent findings: Whereas transmitted drug resistance in LMIC is still limited, resistance in pregnant women as a consequence of suboptimal ART for the prevention of vertical transmission is frequent and dependent on viral subtype and load. Accumulation of drug resistance during first-line ART depends on the frequency of monitoring, whereas mutational patterns are influenced by type of ART and, partly, viral subtype. Summary: Optimized ART for prevention of mother-to-child transmission and closer monitoring of ART programs with the inclusion of viral load may help reducing unnecessary development of HIV drug resistance in LMIC and preserve the limited available treatment options. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.
    Original languageEnglish
    Pages (from-to)27-37
    Number of pages10
    JournalCurrent Opinion in HIV and AIDS
    Volume5
    Issue number1
    Publication statusPublished - Jan 2010

    Keywords

    • Antiretroviral therapy
    • HIV-1 drug resistance
    • Low-middle income countries
    • Therapeutic sequencing
    • Viral load

    Fingerprint

    Dive into the research topics of 'Resistance considerations in sequencing of antiretroviral therapy in low-middle income countries with currently available options'. Together they form a unique fingerprint.

    Cite this