Early Warning Indicators for Population-Based Monitoring of HIV Drug Resistance in 6 African Countries
CLINICAL INFECTIOUS DISEASES
Joint Clinic Research Center - United Arab Emirates, University of Amsterdam, University of Lagos, University of Witwatersrand, Coast Prov Gen Hosp, Copt Hosp, Lusaka Trust Hosp, Muelmed Hosp, Newlands Clin
Human immunodeficiency virus (HIV) RNA testing and HIV drug resistance (HIVDR) testing are not routinely available for therapeutic monitoring of patients receiving antiretroviral therapy (ART) in resource-limited settings. World Health Organization HIVDR early warning indicators (EWIs) assess ART site factors known to favor the emergence of HIVDR. HIV drug resistance EWI monitoring was performed within the PharmAccess African Studies to Evaluate Resistance Monitoring (PASER-M) study, comprising 13 ART sites in 6 African countries. Early warning indicator assessment in the PASER network identified vulnerable aspects of ART programs and triggered interventions aimed at minimizing HIVDR emergence. Additionally, data suggest an advantage of medication possession ratio over on-time antiretroviral drug pickup in identifying patients at risk for HIVDR development.