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Revista Cubana de Medicina

versión impresa ISSN 0034-7523versión On-line ISSN 1561-302X

Resumen

LARREA FABRA, Roberto  y  ROQUE ACOSTA, María del Carmen. Management of the therapeutical failure to the antiretroviral drugs in  resource- limited settings. Rev cubana med [online]. 2007, vol.46, n.3. ISSN 0034-7523.

The resistance of HIV to all kinds of drugs is still developing, which allows the spreading of resistant strains and compromises the contention of the AIDS pandemic. The HIV positive cases from Bonalaja that attended the AIDS Clinic of Rustenburg between April 2004 and November 2005 were studied to evaluate the effect of serial exercises of practical training and of the monitoring of the failure of the therapeutical regime on the resistance to antiretroviral drugs, and on the cost of complementary investigations. Serial tests of CD4 and viral burden were performed among the patients under antiretroviral treatment, with closed computerized monitoring of the failure/resistance. It was proved that 2 446 patients were treated with high efficiency antiretroviral therapy, but in 190 (7.8 %) of them the criteria of failure to the therapeutics was evident. The strategies based on the early detection of the failure with sequential planning of other antiretroviral regimes allowed the control of reduction of the resistance without doing expensive tests.  It was possible to revert the failure in 58 cases (30.5 %), whereas in 132 persisted the management of the therapeutic failure at the end of the period.  It was concluded that the resistance to antiretroviral drugs and the cost of investigations could be remarkably reduced as a result of the effect of the practical training exercises and of the closed monitoring and management of the target population group in  the therapeutic failure regime.

Palabras clave : Resistance; antiretroviral agents; AIDS.

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