Global report on early warning indicators of HIV drug resistance; 2016 (sólo en inglés)

This global report is based on 59 countries that reported data from more than 12 000 clinics from cohorts of patients receiving ART between 2004 and 2014. The report includes the most recent clinic-level data reported to WHO in 2015–2016 and reflects a lag due to the 12 month cohort reporting period. Globally, amongst the clinics reporting data, high levels of appropriate antiretroviral (ARV) drug prescribing were observed, with over 99% of people prescribed regimens according to national or international HIV treatment guidelines. Global levels of LTFU at 12 months during the same period averaged 20%, exceeding the WHO-recommended target of 15%. Moreover, global levels of LTFU among clinics reporting data increased significantly over time, from 11.9% in 2004 to 24.5% in 2012 (p<0.001). Globally, retention on ART at 12 months averaged only 73.5% amongst clinics reporting data, falling short of the WHO-recommended target of 85% or above. Estimates of retention varied considerably across regions. Adherence, as estimated by on-time pill pick-up and on-time appointment keeping, fell below global targets. On-time pill pick-up was a strong predictor of clinic-level viral load suppression (p<0.001) suggesting that identifying clinics with less-than-desirable pill pick-up, then targeting their patient populations for adherence interventions, may lead to improvements in overall population-level outcomes. Amongst 1150 clinics monitoring drug stock outs, 35.7% had at least one drug stock out of routinely dispensed ARV drugs during their respective reporting year, thus failing to attain the WHO-recommended target of no ARV drug stock outs.