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--In recent years, implementation of antiretroviral therapy in developing countries with a high prevalence of HIV-1 has been recognised as a public health priority. Consequently, the availability ofantiretroviral combination therapy for people with HIV is increasing rapidly in sub-Saharan Africa. --HIV treatment programmes are implemented according to the standardised, simplified public health guidelines developed by the World Health Organization (WHO). --However, the implementation of treatment programmes in Africa is hindered by several factors, including the lack of adequate immunological and virological laboratory monitoring, insufficient support for adherence to therapy, vulnerable health care systems and the use of suboptimal drug combinations. --These suboptimal treatment conditions increase the risk that resistant virus strains will emerge that are less susceptible to standard first-line combination therapy, thus threatening the long-term success of the treatment programmes. --The WHO has initiated HIVResNet, an international expert advisory board that has developed a global strategy for surveillance and prevention of antiretroviral drug resistance. --The Dutch initiative known as 'PharmAccess African studies to evaluate resistance' (PASER) is contributing to this strategy by creating a surveillance network in sub-Saharan Africa.

Type

Journal article

Journal

Nederlands tijdschrift voor geneeskunde

Publication Date

12/2007

Volume

151

Pages

2666 - 2671

Addresses

Academisch Medisch Centrum/Universiteit van Amsterdam, Stichting PharmAccess International, Center for Poverty-related Communicable Diseases, Amsterdam.

Keywords

Humans, HIV-1, HIV Infections, Acquired Immunodeficiency Syndrome, Anti-HIV Agents, Treatment Outcome, Antiretroviral Therapy, Highly Active, Risk Factors, Patient Compliance, Drug Resistance, Viral, Africa