Current HIV Treatment Options Are Getting Exhausted In Resource-Limited Settings

Affordable third-line antiretrovirals are urgently needed in resource-limited contexts, according to research in Kenya published in the online edition of AIDS Journal. The study showed that a quarter of patients had exhausted current treatment options and only 18% had the virus that was fully susceptible to the three top classes of anti-HIV medicines.

“This study in the Kenyan national ART program suggests that about 27% of patients with second-line failure are in need of a switch to a third-line therapy, with 25% demonstrating complete exhaustion of alternative first and second-line regimens,” state the authors. “These data indicate an urgent need for increasing access to third-line drugs.”

Virological failure of second-line therapy has been reported in over a third of patients in sub-Saharan Africa. However, there are few data on the prevalence of drug resistance among these patients.

Recommended third-line drugs are costly, typically running between 6 and 14 times more than first- and second-line therapies. Providing these drugs is a challenge for treatment programs in low- and middle-income countries, with Brazil currently spending at least 40% of its ART budget on the 5% of patients in need of third-line treatment.