KAMPALA - The prevalence of drug-resistant HIV strains in Uganda has risen from 8.6 percent to 12 percent in the last five years, one of the highest rates in Sub-Saharan Africa, according to a recent study.
The PharmAccess African Studies to Evaluate Resistance (PASER) monitoring cohort study report for 2008-2012 found that the prevalence of transmitted drug resistance among people who have never taken life-prolonging antiretroviral (ARV) medication was substantially higher in Uganda.
ARVs were available at least five years earlier in Uganda than in the five other PASER countries - Kenya, Nigeria, South Africa, Zambia and Zimbabwe - where drug resistance was estimated at 5 percent in selected areas of those countries.
The Ugandan study was based on results from the capital, Kampala, the western town of Fort Portal, and the eastern town of Mbale.
HIV drug resistance occurs when patients do not respond to prescribed ARVs, and their health deteriorates despite taking the drugs correctly and consistently. Patients who have become resistant must start taking a more expensive second-line regimen of medication. HIV-positive people with drug-resistant strains can transmit them to others.
"Drug-resistant HIV variants selected during ART [antiretroviral treatment] failure have the potential to limit the response to subsequent lines of treatment, and constitute a reservoir for onward transmission [of drug resistance] to newly infected individuals," the authors said. "Drug-resistant HIV may severely restrict therapeutic options, and treatment costs will greatly increase when more people need second- and third-line ART regimens."
According to the study, the overall drug resistance in patients starting on first-line treatment in the six PASER countries stands at 5.6 percent. Most patients had resistance to a class of ARVs called non-nucleoside reverse transcriptase inhibitors (NNRTIs), which include commonly used medications such as nevirapine and efavirenz.
The report revealed that poor treatment adherence to ARVs, shortage of health professionals, limited training, deficient adherence counselling, inconsistent drug supply and weak enforcement of quality standards were among the causes of HIV drug resistance...
Access the latest information on HIV and AIDS. AIDSPortal offers you access to the latest information on: policy initiatives, programmatic subjects, news stories, events and country specific issues for: Africa, Asia, Caribbean, Europe, Latin America, North America.