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Expanded availability of antiretroviral therapy (ART) in resource-limited settings has led to improved outcomes among HIV-infected people — but also to more failures of initial treatment regimens, caused by adherence problems or transmitted resistance. Understanding the resistance consequences of first-line treatment failure is critical to planning management strategies for second-line therapy. Investigators recently reviewed data from resource-limited settings on the emergence of HIV drug resistance among individuals for whom first-line therapy has failed, as well as on clinical and resistance outcomes of those treated with second-line ART.
Most first-line ART regimens consist of a nonnucleoside reverse transcriptase inhibitor (NNRTI) plus …