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The rapid scale-up of antiretroviral therapy (ART) during the past decade has led to dramatic reductions in morbidity and mortality. Efforts are now focused on maintaining virologic control to minimize the development of drug resistance and the need for switches to second-line therapy. Regular viral-load monitoring is recommended for detecting treatment failure but is not always readily available. Two recent reports highlight the benefits of such monitoring.
Barth and colleagues detailed the consequences of drug resistance accumulating during first-line therapy in a cohort of 836 patients in South Africa who were infected with HIV subtype C. All the patients received nonnucleoside reverse transcriptase inhibitor (NNRTI)-based first-line ther…