Abstract
Accurate HIV viral load monitoring is the gold standard for measurement of response to antiretroviral therapy (ART). It is the best marker to detect treatment failure and guide the decision to switch to second-line ART. With more than 10 million people on ART in sub-Saharan Africa, and estimated rates of first-line failure of 10% on treatment,1,2 the small numbers of patients who actually switch regimens3 suggest that many individuals are lost to follow-up or maintained on failing regimens. One of the potential benefits of routine viral load monitoring is a shortening of time spent on failing regimens, thus, avoiding selection of drug resistance mutations.
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