Abstract
The HIV/AIDS epidemic is an ongoing threat to public health. Its elimination requires greater efforts to broaden antiretroviral treatment coverage, availability and personalization. HIV drug resistance is currently a global problem due to its continuing increase in recent years, undermining efficacy of antiretroviral therapy. Pretreatment HIV drug-resistance surveillance is part of WHO's strategy for addressing antiretroviral drug resistance. This paper describes and analyzes pretreatment HIV drug-resistance surveillance in Cuba. It presents a chronology of HIV resistance studies in untreated patients, along with their results and programmatic actions related to first- and second-line treatment regimens. Cuba's incorporation into the Global HIV Drug Resistance Surveillance Laboratories Network and the advantages of having a WHO-designated laboratory in which to conduct periodic studies of HIV drug-resistance surveillance are described. HIV drug-resistance surveillance in Cuba is a necessary tool in HIV/AIDS monitoring and control, as it obtains population-scale data used to inform programmatic decisions related to optimizing first- and second-line treatments for children and adults, as well as helping meet goals of eliminating HIV transmission.
Highlights
Antiretroviral therapy (ART) is one of the most significant advances in battling the HIV/AIDS epidemic
According to WHO criteria, lowering the prevalence of pretreatment HIV drug resistance to
LISIDA has played an active role in HIVResNet since joining the network, which has led to the introduction of new methodologies for analyzing HIV drug resistance in Cuba
Summary
Antiretroviral therapy (ART) is one of the most significant advances in battling the HIV/AIDS epidemic. Monitoring and surveillance activities have been specified in several editions of the Cuban Ministry of Public Health’s (MINSAP) National Strategic Plan for Sexually Transmitted Infections (STI), HIV/AIDS and Hepatitis.[5,6] Surveillance activities include periodic studies of HIV drug resistance in patients who have not received ART, useful to MINSAP as it evaluates current and potential treatment regimens, since pretreatment resistance to ARVs in use in Cuba can affect patient results and strategies for meeting national and global goals for HIV/AIDS elimination.
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