title: A new model to monitor the virological efficacy of antiretroviral treatment in resource-poor countries.
abstract: Monitoring the efficacy of antiretroviral treatment in developing countries is difficult because these countries have few laboratory facilities to test viral load and drug resistance. Those that exist are faced with a shortage of trained staff, unreliable electricity supply, and costly reagents. Not only that, but most HIV patients in resource-poor countries do not have access to such testing. We propose a new model for monitoring antiretroviral treatment in resource-limited settings that uses patients' clinical and treatment history, adherence to treatment, and laboratory indices such as haemoglobin level and total lymphocyte count to identify virological treatment failure, and offers patients future treatment options. We believe that this model can make an accurate diagnosis of treatment failure in most patients. However, operational research is needed to assess whether this strategy works in practice.
authors.affiliation: Infectious Disease Institute, Faculty of Medicine, Makerere University, Kampala, Uganda. bcoleb@itg.be
authors.forename: Robert
authors.initials: R
authors.lastname: Colebunders
authors.forename: Kamya R
authors.initials: KR
authors.lastname: Moses
authors.forename: John
authors.initials: J
authors.lastname: Laurence
authors.forename: Hasan M
authors.initials: HM
authors.lastname: Shihab
authors.forename: Fred
authors.initials: F
authors.lastname: Semitala
authors.forename: Fred
authors.initials: F
authors.lastname: Lutwama
authors.forename: Sabrina
authors.initials: S
authors.lastname: Bakeera-Kitaka
authors.forename: Lut
authors.initials: L
authors.lastname: Lynen
authors.forename: Lisa
authors.initials: L
authors.lastname: Spacek
authors.forename: Steven J
authors.initials: SJ
authors.lastname: Reynolds
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Quinn
authors.forename: Brant
authors.initials: B
authors.lastname: Viner
authors.forename: Harriet
authors.initials: H
authors.lastname: Mayanja-Kizza
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active; D018791:CD4 Lymphocyte Count; D003906:Developing Countries; D016903:Drug Monitoring; D024882:Drug Resistance, Viral; D006678:HIV / Q000187:drug effects / Q000235:genetics / Q000502:physiology; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D010349:Patient Compliance; D017211:Treatment Failure; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D006454:Hemoglobins