via Aidsmap, by Carole Leach-Lemens
Poor adherence rather than drug resistance appears more likely to be the cause of virological failure among patients on second-line ART in resource-poor settings, according to a systematic review and meta-analysis published in the advance online edition of AIDS.
The authors note caution should be taken when reviewing these estimates as there were considerable differences between the studies as well as substantial statistical differences.
While most of the studies did not provide enough information to be able to distinguish conclusively between poor adherence and drug resistance as reasons for virological failure, in those that did poor adherence was the primary cause.
Nonetheless these findings highlight the limited options available after second line in resource-poor settings, notably where drug resistance is the cause of virological failure.
The researchers also stress the importance of improved access to greater virological monitoring as well as more intensive adherence counselling before resistance mutations develop.
The scale-up of ART in resource-poor settings has had a considerable effect on reducing death and disease. Standardised regimens notably simple, affordable fixed-dose combination therapies have facilitated adherence with rates comparable to those in resource-rich settings.
Read the rest.
[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]
Poor adherence rather than drug resistance appears more likely to be the cause of virological failure among patients on second-line ART in resource-poor settings, according to a systematic review and meta-analysis published in the advance online edition of AIDS. The cumulative pooled proportion of the 2035 adults comprising the 19 studies from eight countries in sub-Saharan Africa and Asia failing virologically was 21.8%, 23.1%, 26.7% and 38.0% at six, 12, 24 and 36 months, respectively.
The authors note caution should be taken when reviewing these estimates as there were considerable differences between the studies as well as substantial statistical differences.
While most of the studies did not provide enough information to be able to distinguish conclusively between poor adherence and drug resistance as reasons for virological failure, in those that did poor adherence was the primary cause.
Nonetheless these findings highlight the limited options available after second line in resource-poor settings, notably where drug resistance is the cause of virological failure.
The researchers also stress the importance of improved access to greater virological monitoring as well as more intensive adherence counselling before resistance mutations develop.
The scale-up of ART in resource-poor settings has had a considerable effect on reducing death and disease. Standardised regimens notably simple, affordable fixed-dose combination therapies have facilitated adherence with rates comparable to those in resource-rich settings.
Read the rest.
[Content that is linked from other sources is for informational purposes and should not construe a Mapping Pathways position.]
No comments:
Post a Comment