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Human Immunodeficiency Virus: Resistance to Antiretroviral Drugs in Developing Countries

  • Rebecca F. Baggaley
  • Maya L. Petersen
  • Marcelo A. Soares
  • Marie-Claude Boily
  • Francisco I. Bastos
Chapter

Abstract

This chapter reviews issues central to understanding the emergence and transmission of drug-resistant human immunodeficiency virus (HIV) and its impact on developing countries. We first give an overview of HIV, HIV treatment using antiretroviral drugs, and access to treatment in developing countries. Then we review current understanding of the impact of adherence and treatment interruption on the emergence of resistance among treated individuals (secondary resistance) and factors contributing to secondary resistance in resource-poor settings. Transmitted (or primary) resistance, which can threaten the effectiveness of antiretroviral regimens among treatment-naïve individuals, is also discussed. Furthermore, we address how antiretroviral delivery systems in developing countries may impact resistance.

Mathematical models of HIV transmission offer important insights into the course of HIV epidemics and how expanded access and policies for antiretroviral delivery in developing countries may impact resistance. We summarize the major findings from published modeling studies and discuss their predictions and limitations. We then review available empirical data on antiretroviral resistance in developing countries. Finally, we discuss the implications of these findings for policy and the monitoring of epidemic trends.

Keywords

Human Immunodeficiency Virus Human Immunodeficiency Virus Infection Acquire Immune Deficiency Syndrome Treatment Interruption Human Immunodeficiency Virus Transmission 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Rebecca F. Baggaley
    • 1
    • 2
  • Maya L. Petersen
    • 3
  • Marcelo A. Soares
    • 4
  • Marie-Claude Boily
    • 5
  • Francisco I. Bastos
    • 6
  1. 1.Department of Infectious Disease EpidemiologyFaculty of Medicine, Imperial CollegeLondonUK
  2. 2.Département de pathologie et microbiologie, Faculté de médecine vétérinaireUniversité de MontréalMontréalCanada
  3. 3.School of Public Health, University of CaliforniaBerkeleyUSA
  4. 4.Department of Genetics, Division of GeneticsFederal University of Rio de Janeiro; Brazilian Cancer Institute, Cidade Universitaria – Ilha do FundaoRio de JaneiroBrazil
  5. 5.Department of Infectious Disease EpidemiologyFaculty of Medicine, Imperial CollegeLondonUK
  6. 6.Laboratory of Health Information, Institute for Communication and Information on Science & TechnologyOswaldo Cruz FoundationRio de JaneiroBrazil

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