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Improving first-line antiretroviral therapy in resource-limited settings

Ford, Nathan
Published in Current opinion in HIV and AIDS. 2010, vol. 5, no. 1, p. 38-47
Abstract PURPOSE OF REVIEW: Access to first-line antiretroviral therapy in resource-limited settings has increased rapidly in the last 5 years. Newer medicines with greater potency and better safety profiles open the possibility for improving first-line antiretroviral therapy for developing countries. RECENT FINDINGS: Several medicines offer the potential to improve the simplicity, safety and efficacy of first-line antiretroviral therapy in resource-limited settings. These include tenofovir, raltegravir, elvitegravir, rilpivirine and protease inhibitors. A number of clinical questions are outstanding, particularly regarding safety in pregnancy and compatibility with drugs to treat common coinfections including tuberculosis. SUMMARY: Simple, affordable regimens were key to the initial emergency response, but the long-term response to HIV calls for a reconsideration of current treatment options. Preconditions for widespread use in developing countries include affordability, simplicity and answers to relevant research questions. In the absence of strong pharmacovigilance systems, cohort monitoring will be critical to assessing the safety profile of new drugs in such settings.
Keywords *Anti-HIV Agents/administration & dosage/adverse effects/economics/therapeuticUse*Developing CountriesDrug Administration ScheduleFemaleHIV Infections/*drug therapy/virologyHIV-1/drug effects*Health Services AccessibilityHumansInfectious Disease Transmission, VerticalPractice Guidelines as TopicPregnancyPregnancy Complications, Infectious/drug therapy/virology*Reverse Transcriptase Inhibitors/administration & dosage/adverseEffects/economics/therapeutic use
PMID: 20046146
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FORD, Nathan, CALMY, Alexandra. Improving first-line antiretroviral therapy in resource-limited settings. In: Current opinion in HIV and AIDS, 2010, vol. 5, n° 1, p. 38-47. doi: 10.1097/COH.0b013e3283339b41 https://archive-ouverte.unige.ch/unige:20941

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Deposited on : 2012-05-23

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