Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future
In the early years of the highly active antiretroviral therapy (HAART) era, HIV with resistance to two or more agents in different antiretroviral classes posed a significant clinical challenge. Multidrug-resistant (MDR) HIV was an important cause of treatment failure, morbidity, and mortality. Treat...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | AIDS Research and Treatment |
| Online Access: | http://dx.doi.org/10.1155/2012/595762 |
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| author | Marianne Harris Bohdan Nosyk Richard Harrigan Viviane Dias Lima Calvin Cohen Julio Montaner |
| author_facet | Marianne Harris Bohdan Nosyk Richard Harrigan Viviane Dias Lima Calvin Cohen Julio Montaner |
| author_sort | Marianne Harris |
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| description | In the early years of the highly active antiretroviral therapy (HAART) era, HIV with resistance to two or more agents in different antiretroviral classes posed a significant clinical challenge. Multidrug-resistant (MDR) HIV was an important cause of treatment failure, morbidity, and mortality. Treatment options at the time were limited; multiple drug regimens with or without enfuvirtide were used with some success but proved to be difficult to sustain for reasons of tolerability, toxicity, and cost. Starting in 2006, data began to emerge supporting the use of new drugs from the original antiretroviral classes (tipranavir, darunavir, and etravirine) and drugs from new classes (raltegravir and maraviroc) for the treatment of MDR HIV. Their availability has enabled patients with MDR HIV to achieve full and durable viral suppression with more compact and cost-effective regimens including at least two and often three fully active agents. The emergence of drug-resistant HIV is expected to continue to become less frequent in the future, driven by improvements in the convenience, tolerability, efficacy, and durability of first-line HAART regimens. To continue this trend, the optimal rollout of HAART in both rich and resource-limited settings will require careful planning and strategic use of antiretroviral drugs and monitoring technologies. |
| format | Article |
| id | doaj-art-2ae0be43757f4dc49a162f730b850984 |
| institution | Kabale University |
| issn | 2090-1240 2090-1259 |
| language | English |
| publishDate | 2012-01-01 |
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| series | AIDS Research and Treatment |
| spelling | doaj-art-2ae0be43757f4dc49a162f730b8509842025-08-20T03:54:43ZengWileyAIDS Research and Treatment2090-12402090-12592012-01-01201210.1155/2012/595762595762Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and FutureMarianne Harris0Bohdan Nosyk1Richard Harrigan2Viviane Dias Lima3Calvin Cohen4Julio Montaner5AIDS Research Program, Providence Health Care Institute, B518 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, CanadaBritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, CanadaCommunity Research Initiative of New England, Boston, MA 02111, USABritish Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, V6Z 1Y6, CanadaIn the early years of the highly active antiretroviral therapy (HAART) era, HIV with resistance to two or more agents in different antiretroviral classes posed a significant clinical challenge. Multidrug-resistant (MDR) HIV was an important cause of treatment failure, morbidity, and mortality. Treatment options at the time were limited; multiple drug regimens with or without enfuvirtide were used with some success but proved to be difficult to sustain for reasons of tolerability, toxicity, and cost. Starting in 2006, data began to emerge supporting the use of new drugs from the original antiretroviral classes (tipranavir, darunavir, and etravirine) and drugs from new classes (raltegravir and maraviroc) for the treatment of MDR HIV. Their availability has enabled patients with MDR HIV to achieve full and durable viral suppression with more compact and cost-effective regimens including at least two and often three fully active agents. The emergence of drug-resistant HIV is expected to continue to become less frequent in the future, driven by improvements in the convenience, tolerability, efficacy, and durability of first-line HAART regimens. To continue this trend, the optimal rollout of HAART in both rich and resource-limited settings will require careful planning and strategic use of antiretroviral drugs and monitoring technologies.http://dx.doi.org/10.1155/2012/595762 |
| spellingShingle | Marianne Harris Bohdan Nosyk Richard Harrigan Viviane Dias Lima Calvin Cohen Julio Montaner Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future AIDS Research and Treatment |
| title | Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future |
| title_full | Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future |
| title_fullStr | Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future |
| title_full_unstemmed | Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future |
| title_short | Cost-Effectiveness of Antiretroviral Therapy for Multidrug-Resistant HIV: Past, Present, and Future |
| title_sort | cost effectiveness of antiretroviral therapy for multidrug resistant hiv past present and future |
| url | http://dx.doi.org/10.1155/2012/595762 |
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