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Beyond first-line HIV treatment regimens: the current state of antiretroviral regimens, viral load monitoring, and resistance testing in resource-limited settings

Kumarasamy, Nagalingeswaran; Krishnan, Sheela

Current Opinion in HIV and AIDS: November 2013 - Volume 8 - Issue 6 - p 586–590
doi: 10.1097/COH.0000000000000004
TREATMENT OPTIMISATION: Edited by David H. Brown Ripin, Charles W. Flexner and Ben Plumley

Purpose of review With the availability of antiretroviral drugs in resource-limited settings, there is a rapid scale-up of antiretroviral therapy in developing countries.

Recent findings The review focuses on the issues faced while patients are on first-line antiretroviral therapy in the absence of viral load monitoring, and the availability and progress of the second-line antiretroviral drugs and the salvage regimens in resource-limited settings.

Summary There is an urgent need for low-cost, low-tech viral load monitoring in resource-limited settings. Fixed-dose combination of antiretrovirals for first-line and second-line therapy will result in better effectiveness. There is a need for newer antiretroviral drugs in resource-limited settings.

YRG CARE Medical Centre, VHS, Chennai, India

Correspondence to Dr N. Kumarasamy, Chief Medical Officer, YRG CARE Medical Centre, VHS, Chennai-600113, India. Tel: +91 917 691 2007; e-mail:

© 2013 Lippincott Williams & Wilkins, Inc.