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Human Immunodeficiency Virus: Resistance to Antiretroviral Drugs in Developing Countries

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Abstract

This chapter reviews issues central to understanding the emergence and transmission of drug-resistant human immunodeficiency virus (HIV) and its impact on developing countries. We first give an overview of HIV, HIV treatment using antiretroviral drugs, and access to treatment in developing countries. Then we review current understanding of the impact of adherence and treatment interruption on the emergence of resistance among treated individuals (secondary resistance) and factors contributing to secondary resistance in resource-poor settings. Transmitted (or primary) resistance, which can threaten the effectiveness of antiretroviral regimens among treatment-naïve individuals, is also discussed. Furthermore, we address how antiretroviral delivery systems in developing countries may impact resistance.

Mathematical models of HIV transmission offer important insights into the course of HIV epidemics and how expanded access and policies for antiretroviral delivery in developing countries may impact resistance. We summarize the major findings from published modeling studies and discuss their predictions and limitations. We then review available empirical data on antiretroviral resistance in developing countries. Finally, we discuss the implications of these findings for policy and the monitoring of epidemic trends.

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Authors and Affiliations

  1. Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College, London, UK

    Rebecca F. Baggaley

  2. Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Montréal, Québec, Canada

    Rebecca F. Baggaley

  3. School of Public Health, University of California, Berkeley, CA, USA

    Maya L. Petersen

  4. Department of Genetics, Division of Genetics, Federal University of Rio de Janeiro; Brazilian Cancer Institute, Cidade Universitaria – Ilha do Fundao, Rio de Janeiro, RJ, Brazil

    Marcelo A. Soares

  5. Department of Infectious Disease Epidemiology, Faculty of Medicine, Imperial College, London, UK

    Marie-Claude Boily

  6. Laboratory of Health Information, Institute for Communication and Information on Science & Technology, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil

    Francisco I. Bastos

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  5. Francisco I. Bastos
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Correspondence to Rebecca F. Baggaley .

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Editors and Affiliations

  1. Advisor Alliance for the Prudent Use of, Tufts University, Kneeland St. 75, Boston, 02111, U.S.A.

    Aníbal de J. Sosa

  2. Dept. Zoology, Makerere University Kampala, Kampala, Uganda

    Denis K. Byarugaba

  3. Fundación Lusara, Playa Rosarito 353, Mexico, 08810, Mexico

    Carlos F. Amábile-Cuevas

  4. Depts. Laboratory Medicine, National Taiwan Univ. Hosp., Taipei, Taiwan R.O.C.

    Po-Ren Hsueh

  5. Centre for Microbiology Research, Kenya Medical Research Institute (KEMRI), Nairobi, 00100, Kenya

    Samuel Kariuki

  6. Dept. Biology, Haverford College, Lancaster Avenue 370, Haverford, 19041, U.S.A.

    Iruka N. Okeke

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Baggaley, R.F., Petersen, M.L., Soares, M.A., Boily, MC., Bastos, F.I. (2010). Human Immunodeficiency Virus: Resistance to Antiretroviral Drugs in Developing Countries. In: Sosa, A., Byarugaba, D., Amábile-Cuevas, C., Hsueh, PR., Kariuki, S., Okeke, I. (eds) Antimicrobial Resistance in Developing Countries. Springer, New York, NY. https://doi.org/10.1007/978-0-387-89370-9_6

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