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JAC Advance Access originally published online on October 16, 2003
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Journal of Antimicrobial Chemotherapy (2003) 52, 747-749
© 2003 The British Society for Antimicrobial Chemotherapy

Leading Article

Antiretroviral therapy in sub-Saharan Africa: myth or reality?

Anthony Kebba*

Medical Research Council Programme on AIDS in Uganda, Uganda Virus Research Institute, Entebbe, Uganda and Department of Immunology, Imperial College London, Chelsea & Westminster Hospital, 369 Fulham Road, London SW10 9NH, UK

Keywords: HIV-1, antiretroviral therapy, Uganda

The first 150 words of the full text of this article appear below.


   Introduction
 
Antiretroviral therapy (ART) in the management of HIV-1 infection is associated with significant reductions in morbidity and mortality.1 Until recently, access to such life-saving therapy in sub-Saharan Africa, a region that bears 70% of the HIV-1 burden,2 has been severely limited. Thanks to the intervention of various individuals, organizations and governments and the resulting price reductions, ART is becoming a possibility for increasing numbers of AIDS patients.

However, many issues remain to be resolved, some real and others myths. When is it appropriate to initiate ART and with which drugs? Are the drugs available at a reasonable price? Should monitoring follow the same approach as in the developed world or should Africa develop its own monitoring protocols? Is ART equally efficacious against non-B subtypes that predominate in Africa? How will the management of opportunistic infections (OIs) be addressed? How should adherence and the associated non-structured treatment interruptions be dealt with? . . . [Full Text of this Article]


   Health infrastructures and ART in Africa
 

   When to start ART and with what first-line regimen? Does ART work in Africans?
 

   Monitoring ART amidst limited resources
 

   Patient adherence to ART amidst limited resources
 

   What does the future hold?
 

   Acknowledgements
 

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