RESEARCH ARTICLE Effectiveness of first-line a

There is an unprecedented global effort to scale-up anti-retroviral treatment (ART) and provide universal access to HIV care to all HIV-infected individuals. In resource-limited settings, outcomes of pediatric HIV treatment have been comparable to outcomes in resource-rich countries [1,2]. Several studies from sub-Saharan Africa have reported the effectiveness of ART using mortality as an outcome among HIV-infected children [2-5]. Moreover, children receiving ART in resource-limited settings have demonstrated low levels of drug toxicity, with rates of adherence and retention similar to those in resource-rich settings [3,4,6-8]. The success story of ART scale-up in resource-limited countries presents a unique challenge with regard to laboratory monitoring of treatment. The therapeutic benefits of ART are often limited by long-term toxicities and evolution of drug-resistant virus [9-11]. In resource-rich countries, HIV treatment is monitored routinel