HIV drug resistance in Africa: an emerging problem that deserves urgent attention

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In 2016, the WHO guidelines on the use of antiretroviral drugs for treating and preventing HIV infection were updated [1]. In these guidelines, WHO recommend antiretroviral therapy (ART) for all people living with HIV. Universal access to HIV treatment is mandatory in order to achieve the goal of United Nations AIDS Program to end the HIV/AIDs epidemic as a public health threat by 2030. However, universal access to treatment is not a sufficient tool to end HIV epidemic if it is not accompanied by the ability to monitor its effectiveness and to make the appropriate changes in the antiretroviral regimen when it fails. In these guidelines, routine viral load is recommended as the preferred monitoring approach to diagnose and confirm treatment failure. Unfortunately, there are too many settings in poor-resource countries in which this essential measure to fight against AIDS is still not available. The potential risk of universal treatment without monitoring viral load or testing genotypic resistance is to create a new epidemic of drug-resistant HIV.

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