A crisis is emerging in Africa in the fight against HIV because of increasing resistance to the most commonly used antiretroviral(ARV) drugs. “The problem is very serious. In our hospital we see more and more patients who after several years of treatment develop resistance to the medicine against the HIV virus”, says internist Furaha Lyamuya. He works at the Kilimanjaro Christian Medical Centre (KCMC), a regional referral hospital in Moshi, a small Tanzanian town at the foot of the Kilimanjaro. “In the hospital we can only see the tip of the iceberg. In the countryside there is fear, because many patients have already died because of the failure of antiretroviral therapy.”
The experience with the failing antiretroviral therapy in KCMC is confirmed in a study conducted in 36 countries between 1998 and 2015. Based on that research, the medical journal The Lancet Infectious Diseases(May 2016 issue) publishes an important article about increasing resistance to one of the most widely used antiretroviral, tenofovir.
Co-author of that article is the Dutch fellow infectious diseases Raph Hamers, affiliated with the Department of Global Health of the Academic Medical Centre in Amsterdam. He is stationed at KCMC for several months as part of his research on HIV therapy resistance in Africa. “Treatment fails in one out of five HIV patients in Africa, and in six out of ten of them it is because the virus has become resistant to tenofovir.”