Preferred antiretroviral drugs for the next decade of scale up
Authors: Isabelle Andrieux-Meyer, Alexandra Calmy, Pedro Cahn, Polly Clayden, Gilles Raguin, Christine Katlama, Marco Vitoria, Andrew Levin, Sharonann Lynch, Eric Goemaere and Nathan Ford, on behalf of the participants of the Art Sequencing meeting, 22-23 September 2011, Geneva, Switzerland
Global commitments aim to provide antiretroviral therapy (ART) to 15 million people living with HIV by 2015, and recent studies have demonstrated the potential for widespread ART to prevent HIV transmission. Increasingly, countries are adapting their national guidelines to start ART earlier, for both clinical and preventive benefits. To maximize the benefits of ART in resourcelimited settings, six key principles need to guide ART choice: simplicity, tolerability and safety, durability, universal applicability, affordability and heat stability. Currently available drugs, combined with those in late-stage clinical development, hold great promise to simplify treatment in the short term. Over the longer term, newer technologies, such as long-acting formulations and nanotechnology, could radically alter the treatment paradigm. This commentary reviews recommendations made in an expert consultation on treatment scale up in resource-limited settings.