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July 10, 2002

Emerging Resistance to Nonnucleoside Reverse Transcriptase Inhibitors: A Warning and a Challenge

Author Affiliations

Author Affiliations: Department of Internal Medicine, University of Utah, Salt Lake City (Drs Trachtenberg and Sande); and Academic Alliance for AIDS Care and Prevention in Africa, Makerere University, Kampala, Uganda (Dr Sande).

JAMA. 2002;288(2):239-241. doi:10.1001/jama.288.2.239

Two decades after the recognition of the human immunodeficiency virus (HIV) epidemic, the potential for widespread treatment of HIV infection is now at a pivotal, yet precarious time. In the United States and Europe, patients with HIV infection are living longer without acquired immunodeficiency syndrome (AIDS)–defining illnesses, new highly active antiretroviral therapy (HAART) strategies are being developed and tested, and resistance testing is becoming a new standard for managing therapy after failure with HAART. Yet in much of the developing world, most notably sub-Saharan Africa, HIV and AIDS are devastating innumerable communities. At a time when the introduction of HAART in Africa is in its infancy, 2 articles in this issue of THE JOURNAL illustrate the crucial role the nonnucleoside reverse transcriptase inhibitors (NNRTIs), as well as the implications of NNRTI resistance, will play in the treatment of HIV in both developed and developing countries.