E-drug: Correct use of antiretrovirals (cont'd)
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In more developed countries the use of highly active antiretroviral
treatment (HAART) has changed the natural history of HIV-1
infection from a deadly to chronic disease. However, currently
available antiretroviral agents cannot eradicate HIV-1 infection.
Therefore, continuous and sustained suppression of HIV-1
replication is important.
Some clinical trials reported suppression of HIV-1 replication in 60%
to 90% of patients. However, in clinical practice less than 50% of
the patients reach undetectable plasma HIV-RNA levels. The
reasons for this are multiple; however, the presence of a high
proportion of patients undergoing suboptimal treatment and
incomplete adherence to treatment are among the major reasons.
This leads to the emergence of HIV-1 strains that become resistant
to antiretrovirals. Antiretroviral drug resistance is associated with
treatment failure, and consequently to higher morbidity and
mortality. Therefore, it is very important to develop a
comprehensive approach on the use of antiretrovirals in
resource-poor settings to treat HIV-1-infected patients and to
prolong the usefulness of these agents in clinical practice.
Daniel Seyoum
Program Manager and Drug Information Specialist
Global Assistance Initiatives
The United States Pharmacopeia
12601 Twinbrook Parkway
Rockville, MD 20852-1970
Tel: (301) 816-8242
Fax: (301) 816-8374
E-mail: dws@usp.org
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