HIV antiretroviral drug resistance in Africa.
Highly active antiretroviral therapy (HAART) has dramatically reduced mortality and morbidity in HIV-infected persons in developed countries. Although the use of HAART remains limited in Africa, there are global efforts to make available these drugs to several million HIV-infected persons on the continent. In this review we examine the impact of HIV genetic diversity on the occurrence of drug-resistance mutations among non-B subtypes, and discuss the implication of resistant strains in programs aimed at implementing antiretroviral treatment (ART) in Africa, with respect to factors that may favor the occurrence of treatment-acquired drug-resistant viruses, ways to monitor for drug resistance, and strategies to limit its occurrence. We assert that antiretroviral drug resistance is an inevitable consequence when providing long-term treatment, and should not be seen as a limitation of providing antiretrovirals to patients in resource-poor settings, but rather a necessary challenge to be incorporated into the rational design of programs that provide ART in Africa.
Nkengasong
John N
JN
Division of HIV/AIDS, STD, TB Laboratory Research, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA. jcn5@cdc.gov
Adje-Toure
Christiane
C
Weidle
Paul J
PJ
D000349:Africa; D019380:Anti-HIV Agents / Q000494:pharmacology*; D024882:Drug Resistance, Viral / Q000235:genetics; D004359:Drug Therapy, Combination; D015658:HIV Infections / Q000188:drug therapy / Q000821:virology; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology*
D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors