Cohort Profile: The PharmAccess African (PASER-M) and the TREAT Asia (TASER-M) Monitoring Studies to Evaluate Resistance—HIV drug resistance in sub-Saharan Africa and the Asia-Pacific

Authors:
  • RORebecca Oyomopito
    Rebecca Oyomopito
  • CKCissy Kityo
    Cissy Kityo
  • PPPraphan Phanuphak
    Praphan Phanuphak
  • MSMargaret Siwale
    Margaret Siwale
  • SSSomnuek Sungkanuparph
    Somnuek Sungkanuparph
  • FCFrancesca Conradie
    Francesca Conradie
  • NKNagalingeswaran Kumarasamy
    Nagalingeswaran Kumarasamy
  • MBMariette E Botes
    Mariette E Botes
  • TSThira Sirisanthana
    Thira Sirisanthana
  • SASaade Abdallah
    Saade Abdallah
  • PLPatrick C K Li
    Patrick C K Li
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Abstract
According to World Health Organization (WHO) estimates, 33.4 million people were infected with the human immunodeficiency virus (HIV) type 1 globally at the end of 2008.1 Sub-Saharan Africa and Asia are the two regions that have the highest HIV prevalence, with 22.4 and 4.7 million people infected, respectively.1 During the 5 years prior, access to combination antiretroviral therapy (ART) in low- and middle-income countries increased 10-fold to reach 4 million people, providing coverage to 28% of those in need.2 Several studies have reported significant reductions in HIV-related morbidity and mortality for individuals with access to treatment in these regions.3–5 In resource-limited settings, to facilitate the rapid expansion of access to ART, WHO recommends a standardized, public-health approach.6 This is in contrast to the individualized patient-management strategies in developed countries, based on routinely available diagnostic monitoring.7 Standardized first-line ART regimens consist of a non-nucleoside reverse transcriptase inhibitor (NNRTI) and a dual nucleoside/nucleotide reverse transcriptase inhibitor (NRTI) backbone, available in some countries as generic fixed-dose combinations.6 Recommended second-line regimens combine a ritonavir-boosted protease inhibitor (PI) with two previously unused and/or recycled NRTIs.6
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