Management of Human Immunodeficiency Virus (HIV) Infection in Adults in Resource-Limited Countries: Challenges and Prospects in Nigeria

RESUMO

Nigeria has an HIV seroprevalence of 5.0with an estimated 3.5 million infected persons. By June 2005; an estimated 28 - 48;000 or 4 - 8of those requiring Anti-Retroviral Treatment (ART) receive it through various means and support. It is targeted that 350;000 and 1 million persons will be on ART by 2006 and 2009 respectively. Clinical studies on ART have demonstrated virological; immunological and survival benefits comparable to those reported in the developed world. Situation analyses and audits in the country have shown promising and comparable findings to results elsewhere. They have also identified areas of potential concern - rational use of ART; adherence and monitoring. As ART scale up is ongoing there is need for continued technical support; laboratory standardization; commodities management / supply and training of health care workers. Simple guidelines and algorithms for ART; care and monitoring to facilitate rapid scaleup should be developed for use in tertiary and non-tertiary facilities in the country. Preventive and ART services should be fully linked. With considerable funding from many sources there is need for good governance; accountability; coordination and continuous provision of resources with cogent targets and objectives in the scale up as we seek to improve survival; quality of life and productivity of patients in Nigeria