Too many HIV-infected patients in Africa are dying due to the difficulty of diagnosing and managing antiretroviral treatment (ART) failure in resource-limited settings. According to an opinion piece co-authored by several AIDS experts, which appears in the latest issue of British medical journal, The Lancet, the current criteria for detecting ART failure in Africa are "unreliable", with many patients going undetected and others being switched to more expensive second-line treatment unnecessarily, "at great cost to individuals, and to programmes".
Most low-income countries lack the resources or the manpower to monitor patients on ART through the use of regular laboratory testing as is standard practice in high-income countries. In Malawi, for example, where only about one in four ART clinics have facilities to conduct CD4-cell counts (a measure of immune system strength) and even fewer can do viral load testing (a measure of the amount of HI virus in the blood), health workers mainly rely on clinical symptoms to detect treatment failure.
But as the authors note, "ART clinics are usually busy and understaffed...In these circumstances, thorough clinical assessment is often impossible and new clinical conditions might be missed."
Please follow the link to the full report on the Plus News-website.
