Author:
Malisa Jemima,Manak Mark,Michelo Clive,Imami Nesrina,Kibirige Catherine N.
Abstract
AbstractThere has been a surge in the emergence of HIV-1 drug resistance in Low and Middle-Income Countries (LMICs) due to poor drug-adherence and limited access to viral load testing, the current standard for treatment-monitoring. It is estimated that only 75% of people living with HIV (PLWH) worldwide have access to viral load testing. In LMICs, this figure is below 50%. In a recent WHO survey in mostly LMICs, 21 out of 30 countries surveyed found HIV-1 first-line pre-treatment drug resistance in over 10% of study participants. In the worst-affected regions, up to 68% of infants born to HIV-1 positive mothers were found to harbour first-line HIV-1 treatment resistance. This is a huge public health concern. Greater access to treatment-monitoring is required in LMICs if the UNAIDS “third 95” targets are to be achieved by 2030. Here, we review the current challenges of viral load testing and present the case for greater utilization of Laboratory-based assays that quantify intracellular HIV-1 RNA and/or DNA to provide broader worldwide access to HIV-1 surveillance, drug-resistance monitoring, and cure-research.
Funder
Chevening
IAVI USAID ADVANCE Program
Medical Research Council
Publisher
Springer Science and Business Media LLC
Reference45 articles.
1. UNAIDS. In Global HIV & AIDS Statistics—Fact sheet (2021).
2. Okoli, C. et al. Undetectable equals untransmittable (U = U): Awareness and associations with health outcomes among people living with HIV in 25 countries. Sex Transm. Infect. 97, 18–26. https://doi.org/10.1136/sextrans-2020-054551 (2021).
3. Feng, Q. et al. Quadruple versus triple combination antiretroviral therapies for treatment naive people with HIV: Systematic review and meta-analysis of randomised controlled trials. BMJ 366, l4179. https://doi.org/10.1136/bmj.l4179 (2019).
4. WHO. Updated Recommendations On First-line and Second-Line Antiretroviral Regimens and Post-Exposure Prophylaxis and Recommendations on Early Infant Diagnosis of HIV. Supplement to the 2016 Consolidated Guidelines on the Use of Antiretroviral Drugs for Treating and Preventing HIV Infection: INTERIM GUIDELINES HIV TREATMENT (2018).
5. Chatzidimitriou, D., Tsotridou, E., Grigoropoulos, P. & Skoura, L. HIV-1: Towards understanding the nature and quantifying the latent reservoir. Acta Virol. 64, 3–9. https://doi.org/10.4149/av_2020_101 (2020).
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献