Antiretroviral Treatment and Travel to Developing Countries

Abstract

An increasing number of persons with human immunodeficiency virus (HIV) infection travel to the developing world. Travelers to tropical countries have an increased risk of acquiring illnesses such as gastroenteritis, malaria, hepatitis, tuberculosis, etc. 1‐4 Persons with HIV infection may be more vulnerable to some of these infections (such as tuberculosis) and also may develop opportunistic infections if they have a weak immune system. 5‐7 With the introduction of antiretroviral (ARV) combination therapies the risk of developing opportunistic infections during travel has decreased but these new treatments can cause new health problems. ARVs have potential side effects and in the case of protease inhibitors, there are frequently interactions with other drugs. An ARV treatment should be monitored with hematological and biochemical tests and also with viral load tests: these tests may not be available in developing countries. Good compliance with the ARV treatment is essential in order to avoid the development of viral resistance. During travel it may be particularly difficult to maintain good compliance because people may change time zones,eat at irregular time intervals,often drink alcohol and wake up late. Patients may prefer to abstain from taking drugs during holidays because they fear that it will reveal their seropositivity. In this paper we will discuss the practical problems concerning initiating and maintaining ARV antiretroviral treatment during travel to developing countries. Initiating ARV Treatment before Traveling