title: [Evaluation of early warning indicators of HIV resistance to antiretroviral (ARV) drugs in Ivory Coast in 2011].
abstract: BACKGROUND
  In 2001, the United Nations recommended that antiretroviral (ARV) drugs be made available in resource-limited countries. However, the use of these large-scale drugs is associated with the development of drug-resistant virus. In Ivory Coast, several health care/treatment centres prescribe antiretroviral drugs. This study aimed to evaluate the programmatic factors associated with high risk of emergence of HIV ARV drug resistance.
  
  
  METHODS
  We conducted a retrospective cohort study involving 20 health care/treatment centres for people living with HIV. The study population consisted of patients who started HIV treatment at the health care/treatment centres in 2008-2009. Sample size calculation was based on WHO sampling method.
  
  
  RESULTS
  Of the 20 health care/treatment centres, 98% of initial prescriptions were in accordance with national guidelines and 20% of health care/treatment centres had 100% of compliant prescriptions. In total, 33% of patients were lost to follow-up during the first 12 months of antiretroviral therapy and 20% of health care/treatment centres had less than 20% of patients lost to follow-up. At 12 months, 51% of patients were under appropriate first-line treatment and 11% of the health care/treatment centres reached the threshold of at least 70% of patients under appropriate first-line treatment. Only one health care/treatment centre didn't experienced an interruption in antiretroviral therapy over 12 months.
  
  
  CONCLUSIONS
  Shortcomings in the treatment of people living with HIV justify the existence of a significant risk of viral resistance to antiretroviral drugs in 2008-2009. In order to minimize this risk prescribing practices should be improved, appointment reminder systems should be implemented and a constant availability of antiretroviral drugs should be ensured.
authors.affiliation: Institut National de Santé Publique, Côte d'Ivoire.
authors.forename: Kouadio Jean
authors.initials: KJ
authors.lastname: Yao
authors.affiliation: Direction de l''Information, de la Planification et de l''Evaluation, Côte d'Ivoire.
authors.forename: Néto Florence
authors.initials: NF
authors.lastname: Damey
authors.affiliation: Unité de Formation et de Recherche des Sciences Médicales, Université FHB, Côte d'Ivoire.
authors.forename: Diby Jean Paul
authors.initials: DJ
authors.lastname: Konan
authors.affiliation: Institut National de Santé Publique, Côte d'Ivoire; Unité de Formation et de Recherche des Sciences Médicales, Université FHB, Côte d'Ivoire.
authors.forename: Joseph
authors.initials: J
authors.lastname: Aka
authors.affiliation: Programme National de Prise en Charge Médicale des Personnes vivant avec le VIH/sida, Côte d'Ivoire.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Aka-Konan
authors.affiliation: Unité de Soin Ambulatoire et de Conseil, Abidjan, Côte d'Ivoire.
authors.forename: Alex
authors.initials: A
authors.lastname: Ani
authors.affiliation: Institut National de Santé Publique, Côte d'Ivoire.
authors.forename: Marguerite Te
authors.initials: MT
authors.lastname: Bonle
authors.affiliation: Institut National de Santé Publique, Côte d'Ivoire; Unité de Formation et de Recherche des Sciences Pharmaceutiques et Biologiques, Université FHB, Côte d'Ivoire.
authors.forename: Dinard
authors.initials: D
authors.lastname: Kouassi
mesh_terms: D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000494:pharmacology*; D015331:Cohort Studies; D007560:Cote d'Ivoire; D024882:Drug Resistance, Viral; D019983:Guideline Adherence; D015658:HIV Infections / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D059012:Lost to Follow-Up; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards*; D012189:Retrospective Studies; D013997:Time Factors
chemical_list: D019380:Anti-HIV Agents
keywords: Early warning indicator; HIV; Ivory Coast; resistance