Recommendations for surveillance of transmitted HIV drug resistance in countries scaling up antiretroviral treatment

Bennett, Diane E., Myatt, Mark, Bertagnolio, Silvia, Sutherland, Donald and Gilks, Charles F. (2008) Recommendations for surveillance of transmitted HIV drug resistance in countries scaling up antiretroviral treatment. Antiviral Therapy, 13 Suppl. 2: 25-36.

Author Bennett, Diane E.
Myatt, Mark
Bertagnolio, Silvia
Sutherland, Donald
Gilks, Charles F.
Title Recommendations for surveillance of transmitted HIV drug resistance in countries scaling up antiretroviral treatment
Journal name Antiviral Therapy   Check publisher's open access policy
ISSN 1359-6535
2040-2058
Publication date 2008-01-01
Year available 2008
Sub-type Article (original research)
Open Access Status Not yet assessed
Volume 13
Issue Suppl. 2
Start page 25
End page 36
Total pages 12
Place of publication London, United Kingdom
Publisher International Medical Press
Language eng
Formatted abstract
Background: The World Health Organization (WHO) HIV drug resistance (HIVDR) threshold survey method was developed for surveillance of transmitted HIVDR in resource-limited countries. The method is being implemented with minimal resources as a routine public health activity to produce comparable results in multiple countries and areas within countries. Transmitted drug resistant HIV strains will be seen first in cities or health districts where antiretroviral treatment (ART) has been widely available for years. WHO recommends countries begin surveillance in these areas.

Methods:
Each survey requires ≤47 specimens from individuals consecutively diagnosed with HIV to categorize resistance to each relevant drug class as <5%, 5-15% or >15%. Use of routinely collected information and remnant specimens is recommended to minimize costs. Site and individual eligibility criteria are designed to minimize inclusion of ARV-experienced individuals and individuals infected before ART was available.

Results: Surveys have been implemented in 21 countries. In this supplement, seven countries report results of <5% transmitted HIVDR in areas where ART has been available for the longest time period. The main challenges in implementation are acquiring sufficient numbers of eligible specimens and optimizing specimen handling.

Conclusion: The WHO HIVDR threshold survey method is feasible in resource-limited countries and produces information relevant to ART and drug resistance prevention planning.
Keyword Resource Limited Settings
Prevention Interventions
Infected Patients
Therapy Programs
Poor Settings
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
 
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