[Status of resistance of HIV-1 strains in Africa: what is the role of viral surveillance networks?].
The human immunodeficiency virus (HIV-1) epidemic has spread dramatically in sub-Saharan African countries. Implementation of active antiretroviral (ARV) therapy programs is urgently needed. However this emergency situation must not extenuate the importance of preliminary studies on ARV resistance of African HIV-1 isolates. Findings show that genetic mutations underlying the resistance of African strains are generally identical to those observed in HIV-1 subtype B in industrialized countries. However the incidence of some mutations associated with mild resistance to protease inhibitors (PI) appears higher in African isolates. The potential impact of these mutations for development of frank resistance to PI is still unclear. The incidence of high-grade resistance markers in untreated subjects is low. While these results do not compromise use of ARV therapy in Africa, they underline the need to set up local networks for patient follow-up and to carry out epidemiological surveillance of HIV-1 resistance. Success of ARV therapies in Africa will also depend on economic and social programs.
Grandadam
M
M
Laboratoire de biologie clinique, HIA Val-de-Grâce, 74 Bd Port Royal, 75230 Paris. 5rt@filnet.fr
Nicand
E
E
Koeck
J L
JL
Caron
M
M
Teyssou
R
R
D000349:Africa; D019380:Anti-HIV Agents / Q000494:pharmacology*; D024882:Drug Resistance, Viral; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D015497:HIV-1 / Q000187:drug effects*; D006801:Humans; D011159:Population Surveillance
D019380:Anti-HIV Agents