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[Unpublished] .  p.Since HIV was first identified as the cause of AIDS, a number of research efforts have been concentrated on identifying and developing antiretroviral compounds to suppress its replication. Over the years, these researches have noted that sustained suppression of HIV replication is achievable through the use of triple antiretroviral therapy. However, reservoirs of HIV in patients under treatment still remain and there are studies which indicate that the virus may not be latent but instead replicating at a slow rate. In this perspective, researchers are seeking alternatives to triple therapy, and looking at quadruple therapy and new classes of drugs. In the meantime, it is generally accepted that combination therapy represents the best treatment option available. Hence, the long-term sustainability and safety of antiretrovirals is emphasized. Given the gross imbalance in availability and access to antiretrovirals between the industrialized and developing countries, a set of guiding principles has been drawn up by the WHO and Joint UN Programme on HIV/AIDS (UNAIDS). Moreover, UNAIDS efforts in improving access to antiretrovirals are being acknowledged, particularly in developing countries.
WHO / UNAIDS hail consensus on cotrimoxazole use for prevention of HIV related infections in Africa.
AIDS WEEKLY. 2000 Apr 17-24; 16-7.This article reports on the recommendation of the WHO/Joint UN Program on AIDS/HIV to promote the use of cotrimoxazole for the prevention of HIV-related infections in Africa. Several arguments have been raised since the recommendation for its use. Controversies lie in its efficacy in treating opportunistic infections despite its use for Pneumocystis carinii pneumonia. Researchers, however, argue that the drug is effective in preventing certain kinds of bacterial pneumonia and diarrheal diseases, as well as certain septicemia. Furthermore, it can also protect the individual against toxoplasmosis and isosporiasis. Another challenge faced in deciding whether to recommend the use of cotrimoxazole is the risk of creating microbial resistance to the drug if it is widely used as a prophylactic. Weighing the use of cotrimoxazole against the two challenges of differing infections and possible resistance in a region like sub-Saharan Africa would still yield to the urgent need of preventing opportunistic infections in people living with AIDS/HIV.