Surveillance of transmitted HIV drug resistance with the WHO threshold survey method in Lilongwe, Malawi
Antiviral Therapy Volume 13, 2008; Supplement 2: 83–87
Malawi is a geographically small, severely impoverished country in Southern Africa with an estimated population of 12.5 million (National Statistics Office [NSO] 1998 population projections), facing one of the world’s most severe generalized HIV epidemics. With an adult (ages 15–49) HIV prevalence of 14.0%, there are an estimated 930,000 adults and children living with HIV. There are ~87,000 AIDS-related deaths annually and up to 190,000 people are currently eligible for antiretroviral therapy (ART). As a major component of their response, the Malawi government began rapidly scaling up a national ART programme in June 2004. Details and rationale of ART delivery in Malawi have previously been described. A standardized ART approach is used which includes several factors. This approach has provided quality treatment and care, and encourages therapy adherence in the context of severely limited resources. Alternative first-line therapy, including zidovudine or efavirenz, is available for patients with severe side effects. Second-line therapy is also available for patients in case of failure to first-line drugs. For adults, this second-line therapy comprises zidovudine plus lamivudine, tenofovir and lopinavir/ritonavir, whereas for children the regimen comprises didanosine plus abacavir and lopinavir/ritonavir.
Co-produced with the International Medical Press.
© 2008 International Medical Press. Reproduced with permission.