title: Early warning indicators for population-based monitoring of HIV drug resistance in 6 African countries.
abstract: Human immunodeficiency virus (HIV) RNA testing and HIV drug resistance (HIVDR) testing are not routinely available for therapeutic monitoring of patients receiving antiretroviral therapy (ART) in resource-limited settings. World Health Organization HIVDR early warning indicators (EWIs) assess ART site factors known to favor the emergence of HIVDR. HIV drug resistance EWI monitoring was performed within the PharmAccess African Studies to Evaluate Resistance Monitoring (PASER-M) study, comprising 13 ART sites in 6 African countries. Early warning indicator assessment in the PASER network identified vulnerable aspects of ART programs and triggered interventions aimed at minimizing HIVDR emergence. Additionally, data suggest an advantage of medication possession ratio over on-time antiretroviral drug pickup in identifying patients at risk for HIVDR development.
authors.affiliation: PharmAccess Foundation, Department of Global Health, Academic Medical Center of the University of Amsterdam, Amsterdam Institute for Global Health and Development, The Netherlands.
authors.forename: Kim C E
authors.initials: KC
authors.lastname: Sigaloff
authors.forename: Raph L
authors.initials: RL
authors.lastname: Hamers
authors.forename: Jack
authors.initials: J
authors.lastname: Menke
authors.forename: Moheb
authors.initials: M
authors.lastname: Labib
authors.forename: Margaret
authors.initials: M
authors.lastname: Siwale
authors.forename: Prudence
authors.initials: P
authors.lastname: Ive
authors.forename: Mariette E
authors.initials: ME
authors.lastname: Botes
authors.forename: Cissy
authors.initials: C
authors.lastname: Kityo
authors.forename: Kishor
authors.initials: K
authors.lastname: Mandaliya
authors.forename: Maureen
authors.initials: M
authors.lastname: Wellington
authors.forename: Akin
authors.initials: A
authors.lastname: Osibogun
authors.forename: Ronald B
authors.initials: RB
authors.lastname: Geskus
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Stevens
authors.forename: Michèle
authors.initials: M
authors.lastname: van Vugt
authors.forename: Tobias F
authors.initials: TF
authors.lastname: Rinke de Wit
mesh_terms: D017954:Africa South of the Sahara / Q000453:epidemiology; D044966:Anti-Retroviral Agents / Q000494:pharmacology* / Q000627:therapeutic use; D015331:Cohort Studies; D003695:Delivery of Health Care; D024882:Drug Resistance, Viral; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology*; D006305:Health Status Indicators; D006801:Humans; D059012:Lost to Follow-Up; D011159:Population Surveillance; D012680:Sensitivity and Specificity; D014944:World Health Organization; D016903:Drug Monitoring
chemical_list: D044966:Anti-Retroviral Agents