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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
Modelling response to HIV therapy without a genotype: An argument for viral load monitoring in resource-limited settings
Journal of Antimicrobial Chemotherapy, Volume 65, No. 4, Article dkq032, Year 2010
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Description
In the absence of widespread access to individualized laboratory monitoring, which forms an integral part of HIV patient management in resource-rich settings, the roll-out of highly active antiretroviral therapy (HAART) in resource-limited settings has adopted a public health approach based on standard HAART protocols and clinical/immunological definitions of therapy failure. The cost-effectiveness of HIV-1 viral load monitoring at the individual level in such settings has been debated, and questions remain over the long-term and population-level impact of managing HAART without it. Computational models that accurately predict virological response to HAART using baseline data including CD4 count, viral load and genotypic resistance profile, as developed by the Resistance Database Initiative, have significant potential as an aid to treatment selection and optimization. Recently developed models have shown good predictive performance without the need for genotypic data, with viral load emerging as by far the most important variable. This finding provides further, indirect support for the use of viral load monitoring for the long-term optimization of HAART in resource-limited settings. © The Author 2010. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved.
Authors & Co-Authors
Revell, Andrew D.
Unknown Affiliation
Wang, Dechao
Unknown Affiliation
Harrigan, P. Richard
Canada, Vancouver
British Columbia Centre for Excellence in Hiv-aids
Hamers, Raph L.
Netherlands, Amsterdam
Amsterdam Umc - University of Amsterdam
Wensing, Annemarie Marie J.
Netherlands, Utrecht
University Medical Center Utrecht
DeWolf, Frank
Netherlands, Amsterdam
Stichting Hiv Monitoring
Nelson, Mark Richard
United Kingdom, London
Chelsea and Westminster Hospital
Geretti, Anna María
United Kingdom, London
The Royal Free Hospital
Larder, Brendan A.
Unknown Affiliation
Statistics
Citations: 22
Authors: 9
Affiliations: 6
Identifiers
Doi:
10.1093/jac/dkq032
ISSN:
14602091
Research Areas
Cancer
Genetics And Genomics
Health System And Policy
Infectious Diseases
Study Design
Cross Sectional Study