 |
|
|
About Our Work: Antiretroviral Therapy (Last Updated: January 2005) |
|
|
Antiretroviral therapy (ART) reduces the incidence of opportunistic
infections and prolongs survival in persons infected with HIV. However, the high
cost and complexity of administering antiretroviral drugs (ARVs) have severely
limited their use in resource limited settings, where most HIV-infected persons
live.
The drug management and other treatment considerations involved in HIV care
programs can be complex. Intolerance to drugs and toxicity can occur. Further,
excellent patient adherence to ART is critical for successful treatment. In many
resource-limited settings where HIV prevalence is high, trained medical
personnel, laboratory services, and drug management systems are severely
limited.
Despite these difficulties, the use of ART is increasing and will probably
become widely available because of several encouraging recent developments:
- The cost of ARVs has decreased dramatically.
- Funding for ART programs is available through the Global Fund to Fight
AIDS, Tuberculosis, and Malaria and the World Bank Multi-Country AIDS Program
(MAP).
- The World Health Organization (WHO) published guidelines for scaling up
ART in resource-limited settings.
- President Bush proposed the President's Emergency Plan for AIDS Relief
(the Emergency Plan) in January 2003. One Emergency Plan goal is to treat 2
million HIV-infected persons with ART in 15 of the world's most affected
countries by 2008.
Since 1998, the U.S. Government (USG) has supported HIV care and treatment
pilot projects in developing countries that provide ART through the Global AIDS
Program (GAP). These programs address the complexities associated with ART
through the use of step-by-step, standardized, clinical decision-making tools or
algorithms for prescribing ARVs that address:
- eligibility for ART;
- selection of first-line regimens;
- alternative ARVs that can be used when drug intolerance or toxicity occur;
- patient adherence;
- medical personnel, laboratory services, and drug management systems.
In Côte d'Ivoire, GAP, with U.S. Government (USG) funding... supports
laboratory testing and monitoring as well as evaluation of Project RETRO-CI, a
collaboration of the Ministry of Health and the CDC, one of the first ART
programs in Africa.
In Kenya, GAP, with USG funding... collaborates with the Kenya
Ministry of Health, the African Medical & Research Foundation (AMREF), and the
Kenya Medical Research Institute (KEMRI) on a HIV care and treatment program
that provides ART for adults living in the Kibera slums of Nairobi. As of
September 2004, nearly 200 HIVinfected persons enrolled in the program had been
started on ART.
How does CDC improve access to ART in developing countries?
CDC works with countries to:
- Develop plans, guidelines, protocols, and training materials for
antiretroviral therapy (ART).
- Develop ART programs, including clinical care, training, drug and health
supplies management, laboratory services, community mobilization, and
monitoring and evaluation activities.
- Conduct research on ART programs.
- Share information on lessons learned through publications and
presentations.
« Go back
|
