HIV antiretroviral drug resistance in Africa

AIDS Rev. Jan-Mar 2004;6(1):4-12.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Africa
  • Anti-HIV Agents / pharmacology*
  • Drug Resistance, Viral* / genetics
  • Drug Therapy, Combination
  • HIV Infections / drug therapy
  • HIV Infections / virology
  • HIV-1 / drug effects*
  • HIV-1 / genetics
  • Humans
  • Reverse Transcriptase Inhibitors / pharmacology*

Substances

  • Anti-HIV Agents
  • Reverse Transcriptase Inhibitors