Emerging HIV-1 drug resistance after roll-out of antiretroviral therapy in sub-Saharan Africa

摘要: Purpose of review This provides an update recent data on the development HIV-1 drug resistance during treatment and its transmission in sub-Saharan Africa after scale-up antiretroviral therapy (ART). Recent findings Evidence is accumulating a rising prevalence transmitted HIV (TDR), predominantly associated with nonnucleoside reverse transcriptase inhibitors (NNRTIs), east southern Africa. Pretherapy first-line failure. Accumulation mutations failure can be prevented by early detection timely switching to second-line ART. Important gaps service delivery programme performance, development, affect considerable proportion ART programmes, particularly respect inadequate supply systems patient retention. The reduction new infections earlier use predicted outweigh risk increasing TDR. Future levels TDR are estimated diminished improving practices regimens. Summary rise To prevent spread sustain effectiveness there need improve systems, retention access routine viral load monitoring. Enhanced monitoring warranted