A new model to monitor the virological efficacy of antiretroviral treatment in resource-poor countries
Monitoring the efficacy of antiretroviral treatment in developing countries is difficult because these countries have few laboratory facilities to test viral load and drug resistance. Those that exist are faced with a shortage of trained staff, unreliable electricity supply, and costly reagents. Not...
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Veröffentlicht in: | The Lancet infectious diseases 2006, Vol.6 (1), p.53-59 |
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creator | Colebunders, Robert Moses, Kamya R Laurence, John Shihab, Hasan M Semitala, Fred Lutwama, Fred Bakeera-Kitaka, Sabrina Lynen, Lut Spacek, Lisa Reynolds, Steven J Quinn, Thomas C Viner, Brant Mayanja-Kizza, Harriet |
description | Monitoring the efficacy of antiretroviral treatment in developing countries is difficult because these countries have few laboratory facilities to test viral load and drug resistance. Those that exist are faced with a shortage of trained staff, unreliable electricity supply, and costly reagents. Not only that, but most HIV patients in resource-poor countries do not have access to such testing. We propose a new model for monitoring antiretroviral treatment in resource-limited settings that uses patients' clinical and treatment history, adherence to treatment, and laboratory indices such as haemoglobin level and total lymphocyte count to identify virological treatment failure, and offers patients future treatment options. We believe that this model can make an accurate diagnosis of treatment failure in most patients. However, operational research is needed to assess whether this strategy works in practice. |
doi_str_mv | 10.1016/S1473-3099(05)70327-3 |
format | Article |
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Those that exist are faced with a shortage of trained staff, unreliable electricity supply, and costly reagents. Not only that, but most HIV patients in resource-poor countries do not have access to such testing. We propose a new model for monitoring antiretroviral treatment in resource-limited settings that uses patients' clinical and treatment history, adherence to treatment, and laboratory indices such as haemoglobin level and total lymphocyte count to identify virological treatment failure, and offers patients future treatment options. We believe that this model can make an accurate diagnosis of treatment failure in most patients. However, operational research is needed to assess whether this strategy works in practice.</description><identifier>ISSN: 1473-3099</identifier><identifier>EISSN: 1474-4457</identifier><identifier>DOI: 10.1016/S1473-3099(05)70327-3</identifier><identifier>PMID: 16377535</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>London: Elsevier Ltd</publisher><subject>Anti-HIV Agents - administration & dosage ; Anti-HIV Agents - therapeutic use ; Antibiotics. Antiinfectious agents. Antiparasitic agents ; Antiretroviral agents ; Antiretroviral Therapy, Highly Active ; Antiviral agents ; Biological and medical sciences ; CD4 Lymphocyte Count ; Developing Countries ; Drug Monitoring ; Drug resistance ; Drug Resistance, Viral ; Hemoglobins - analysis ; HIV - drug effects ; HIV - genetics ; HIV - physiology ; HIV Infections - drug therapy ; HIV Infections - virology ; Human viral diseases ; Humans ; Immunodeficiencies ; Immunodeficiencies. Immunoglobulinopathies ; Immunopathology ; Infectious diseases ; LDCs ; Lymphocytes ; Medical sciences ; Patient Compliance ; Pharmacology. Drug treatments ; Reagents ; Treatment Failure ; Viral diseases ; Viral diseases of the lymphoid tissue and the blood. Aids ; Viral Load</subject><ispartof>The Lancet infectious diseases, 2006, Vol.6 (1), p.53-59</ispartof><rights>2006 Elsevier Ltd</rights><rights>2006 INIST-CNRS</rights><rights>Copyright Elsevier Limited Jan 2006</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c420t-dde64d97f092820a683fa9572afeb76bd234c3f19f72d5aa778e3f2025494d0f3</citedby><cites>FETCH-LOGICAL-c420t-dde64d97f092820a683fa9572afeb76bd234c3f19f72d5aa778e3f2025494d0f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/201613673?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,3550,4024,27923,27924,27925,45995,64385,64387,64389,72469</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17370972$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16377535$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Colebunders, Robert</creatorcontrib><creatorcontrib>Moses, Kamya R</creatorcontrib><creatorcontrib>Laurence, John</creatorcontrib><creatorcontrib>Shihab, Hasan M</creatorcontrib><creatorcontrib>Semitala, Fred</creatorcontrib><creatorcontrib>Lutwama, Fred</creatorcontrib><creatorcontrib>Bakeera-Kitaka, Sabrina</creatorcontrib><creatorcontrib>Lynen, Lut</creatorcontrib><creatorcontrib>Spacek, Lisa</creatorcontrib><creatorcontrib>Reynolds, Steven J</creatorcontrib><creatorcontrib>Quinn, Thomas C</creatorcontrib><creatorcontrib>Viner, Brant</creatorcontrib><creatorcontrib>Mayanja-Kizza, Harriet</creatorcontrib><title>A new model to monitor the virological efficacy of antiretroviral treatment in resource-poor countries</title><title>The Lancet infectious diseases</title><addtitle>Lancet Infect Dis</addtitle><description>Monitoring the efficacy of antiretroviral treatment in developing countries is difficult because these countries have few laboratory facilities to test viral load and drug resistance. Those that exist are faced with a shortage of trained staff, unreliable electricity supply, and costly reagents. Not only that, but most HIV patients in resource-poor countries do not have access to such testing. We propose a new model for monitoring antiretroviral treatment in resource-limited settings that uses patients' clinical and treatment history, adherence to treatment, and laboratory indices such as haemoglobin level and total lymphocyte count to identify virological treatment failure, and offers patients future treatment options. We believe that this model can make an accurate diagnosis of treatment failure in most patients. However, operational research is needed to assess whether this strategy works in practice.</description><subject>Anti-HIV Agents - administration & dosage</subject><subject>Anti-HIV Agents - therapeutic use</subject><subject>Antibiotics. Antiinfectious agents. Antiparasitic agents</subject><subject>Antiretroviral agents</subject><subject>Antiretroviral Therapy, Highly Active</subject><subject>Antiviral agents</subject><subject>Biological and medical sciences</subject><subject>CD4 Lymphocyte Count</subject><subject>Developing Countries</subject><subject>Drug Monitoring</subject><subject>Drug resistance</subject><subject>Drug Resistance, Viral</subject><subject>Hemoglobins - analysis</subject><subject>HIV - drug effects</subject><subject>HIV - genetics</subject><subject>HIV - physiology</subject><subject>HIV Infections - drug therapy</subject><subject>HIV Infections - virology</subject><subject>Human viral diseases</subject><subject>Humans</subject><subject>Immunodeficiencies</subject><subject>Immunodeficiencies. Immunoglobulinopathies</subject><subject>Immunopathology</subject><subject>Infectious diseases</subject><subject>LDCs</subject><subject>Lymphocytes</subject><subject>Medical sciences</subject><subject>Patient Compliance</subject><subject>Pharmacology. Drug treatments</subject><subject>Reagents</subject><subject>Treatment Failure</subject><subject>Viral diseases</subject><subject>Viral diseases of the lymphoid tissue and the blood. 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Antiinfectious agents. Antiparasitic agents</topic><topic>Antiretroviral agents</topic><topic>Antiretroviral Therapy, Highly Active</topic><topic>Antiviral agents</topic><topic>Biological and medical sciences</topic><topic>CD4 Lymphocyte Count</topic><topic>Developing Countries</topic><topic>Drug Monitoring</topic><topic>Drug resistance</topic><topic>Drug Resistance, Viral</topic><topic>Hemoglobins - analysis</topic><topic>HIV - drug effects</topic><topic>HIV - genetics</topic><topic>HIV - physiology</topic><topic>HIV Infections - drug therapy</topic><topic>HIV Infections - virology</topic><topic>Human viral diseases</topic><topic>Humans</topic><topic>Immunodeficiencies</topic><topic>Immunodeficiencies. Immunoglobulinopathies</topic><topic>Immunopathology</topic><topic>Infectious diseases</topic><topic>LDCs</topic><topic>Lymphocytes</topic><topic>Medical sciences</topic><topic>Patient Compliance</topic><topic>Pharmacology. Drug treatments</topic><topic>Reagents</topic><topic>Treatment Failure</topic><topic>Viral diseases</topic><topic>Viral diseases of the lymphoid tissue and the blood. 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subjects | Anti-HIV Agents - administration & dosage Anti-HIV Agents - therapeutic use Antibiotics. Antiinfectious agents. Antiparasitic agents Antiretroviral agents Antiretroviral Therapy, Highly Active Antiviral agents Biological and medical sciences CD4 Lymphocyte Count Developing Countries Drug Monitoring Drug resistance Drug Resistance, Viral Hemoglobins - analysis HIV - drug effects HIV - genetics HIV - physiology HIV Infections - drug therapy HIV Infections - virology Human viral diseases Humans Immunodeficiencies Immunodeficiencies. Immunoglobulinopathies Immunopathology Infectious diseases LDCs Lymphocytes Medical sciences Patient Compliance Pharmacology. Drug treatments Reagents Treatment Failure Viral diseases Viral diseases of the lymphoid tissue and the blood. Aids Viral Load |
title | A new model to monitor the virological efficacy of antiretroviral treatment in resource-poor countries |
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