Hidden drug resistant HIV to emerge in the era of universal treatment access in Southeast Asia.
other · Level V
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- Record sourced from PubMed, PMID 20544022.
- Also identified by DOI 10.1371/journal.pone.0010981 and PMC identifier PMC3070962.
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Abstract
BACKGROUND: Universal access to first-line antiretroviral therapy (ART) for HIV infection is becoming more of a reality in most low and middle income countries in Asia. However, second-line therapies are relatively scarce. METHODS AND FINDINGS: We developed a mathematical model of an HIV epidemic in a Southeast Asian setting and used it to forecast the impact of treatment plans, without second-line options, on the potential degree of acquisition and transmission of drug resistant HIV strains. We show that after 10 years of universal treatment access, up to 20% of treatment-naïve individuals with HIV may have drug-resistant strains but it depends on the relative fitness of viral strains. CONCLUSIONS: If viral load testing of people on ART is carried out on a yearly basis and virological failure leads to effective second-line therapy, then transmitted drug resistance could be reduced by 80%. Greater efforts are required for minimizing first-line failure, to detect virological failure earlier, and to procure access to second-line therapies.