Encyclopedia of AIDS

Living Edition
| Editors: Thomas J. Hope, Douglas Richman, Mario Stevenson

Antiretroviral Treatment in Resource-Limited Settings

  • Charles Muiruri
  • Habib R. Omar
  • John A. Bartlett
Living reference work entry
DOI: https://doi.org/10.1007/978-1-4614-9610-6_441-1

Definition

Antiretroviral therapy (ART) treatment has been proven to slow the progression of disease and reduce the risk of transmission for individuals with human immunodeficiency virus (HIV) infection. The goal of ART treatment is to completely inhibit viral replication in vivo and sustain the effects for as long as possible.

Introduction on Impact

Access to ART in resource-limited settings (RLS) has provided opportunity for infected patients to achieve nearly normal life expectancy with clear health gains. Before 2001, many people in RLS did not have access to ART due to the high cost and lack of availability of antiretroviral drugs (ARVs). Under special terms in international trade law, manufacturers in RLS began to produce generic drugs in 2001. This production expanded ART coverage, and by 2012, 9.7 million individuals representing 61 % of all eligible HIV-infected patients under the 2010 World Health Organization (WHO) HIV treatment guidelines were on treatment in RLS. These...

Keywords

Hepatitis Depression Tuberculosis Pancreatitis Anemia 
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References

  1. Cohen MS, et al. Prevention of HIV-1 infection with early antiretroviral therapy. N Engl J Med. 2011;365:493–505.PubMedCentralCrossRefPubMedGoogle Scholar
  2. Gilks C, et al. WHO public health approach to ART against HIV in resource-limited settings. Lancet. 2006;368:505–10.CrossRefPubMedGoogle Scholar
  3. Hamers R, et al. Merging HIV-1 drug resistance after roll-out of antiretroviral therapy in sub-Saharan Africa. Curr Opin HIV AIDS. 2013;8(1):19–26. doi:10.1097/COH.0b013e32835b7f94.CrossRefPubMedGoogle Scholar
  4. Institute of Medicine. Monitoring HIV care in the United States; indicators and data systems. 2012. http://iom.edu/~/media/Files/Report%20Files/2012/Monitoring-HIV-Care-in-the-United-States/Monitor-ingHIV_rb.pdf. Accessed 15 May 2015
  5. Kantor R, et al. Pre-treatment HIV drug resistance and HIV-1 subtype C are independently associated with virologic failure: results from the multi-national PEARLS (ACTG A5175) clinical trial. Clin Infect Dis. 2015;60:1426.PubMedGoogle Scholar
  6. Mugavero MJ, Davila JA, Nevin CR, Giordano TP. From access to engagement: measuring retention in outpatient HIV clinical care. AIDS Patient Care STDS. 2010;24:607–13.PubMedCentralCrossRefPubMedGoogle Scholar
  7. PEPFAR. 2015 annual report to congress. 2015. http://www.pepfar.gov/documents/organization/239006.pdf. Accessed 15 May 2015.
  8. Rosen S, Fox MP. Retention in HIV Care between testing and treatment in Sub-Saharan Africa: a systematic review. PLoS Med. 2011;8(7), e1001056. doi:10.1371/journal.pmed.1001056.PubMedCentralCrossRefPubMedGoogle Scholar
  9. UNAIDS. Global report: UNAIDS report on the global AIDS epidemic 2013. 2013. http://www.unaids.org/sites/default/files/en/media/unaids/contentassets/documents/epidemiology/2013/gr2013/UNAIDS_Global_Report_2013_en.pdf. Accessed 15 May 2015.
  10. Wallis CL, et al. Drug susceptibility and resistance mutations after first-line failure in resource limited settings. Clin Infect Dis. 2014;59(5):706–15.PubMedCentralCrossRefPubMedGoogle Scholar
  11. World Health Organization. Scaling up antiretroviral therapy in resource-limited settings. Guidelines for a public health approach. 2002. https://www.who.int/hiv/pub/prev_care/ScalingUp_E.pdf. Accessed 15 May 2015.
  12. Word Health Organization. 2010 ART guidelines for adults and adolescents – evidence map. 2004. http://www.who.int/hiv/topics/treatment/evidence/en/. Accessed 15 May 2015.
  13. World Health Organization. Antiretroviral drugs for treating pregnant women and preventing HIV infection in infants: towards universal access: recommendations for a public health approach. 2006. http://www.who.int/hiv/pub/mtct/antiretroviral/en/index.html. Accessed 15 May 2015.
  14. World Health Organization. The strategic use of antiretrovirals for treatment and prevention of HIV infection. Report of a WHO technical consultation. 2011. http://www.who.int/hiv/pub/meetingreports/consultation_20111116/en/. Accessed 15 May 2015.
  15. Word Health Organization. Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection. 2013. http://www.who.int/hiv/pub/guidelines/arv2013/download/en/. Accessed 15 May 2015.

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Charles Muiruri
    • 1
  • Habib R. Omar
    • 2
  • John A. Bartlett
    • 1
    • 2
    • 3
  1. 1.Duke Global Health InstituteDurhamUSA
  2. 2.Kilimanjaro Christian Medical CenterMoshiTanzania
  3. 3.Duke University Medical CenterDurhamUSA