Most people taking second-line ART in sub-Saharan Africa achieve viral suppression but there's a need for third-line treatment options
Approximately 85% of people switched to protease inhibitor-based second-line antiretroviral (ART) in sub-Saharan Africa achieve and maintain an undetectable viral load with their new regimen, according to research in the online edition of Clinical Infectious Diseases.
Non-standard first-line treatment, poor adherence and previous resistance to protease inhibitors were also associated with the virological failure of second-line treatment. Genotypic resistance testing on people with a viral load above 1000 copies/ml showed that a fifth had major resistance to drugs in the protease inhibitor class and that resistance to nucleoside reverse transcriptase inhibitors (NRTIs) was widespread.
However, while this study found that future treatment of individuals with failure of second-line ART requires third-line drug options, these are currently unavailable and/or unaffordable in the public sector in sub-Saharan Africa.