Important note: Information in this article was accurate in October 2002. The state of the art may have changed since the publication date.AIDSWEEKLY Plus; October 21, 2002
Michael Greer, Senior Medical Writer
"Among persons in North America who are newly infected with the human immunodeficiency virus (HIV), the prevalence of transmitted resistance to antiretroviral drugs has been estimated at 1-11%," according to Susan J. Little and colleagues at the University of California at San Diego, South San Francisco-based ViroLogic, Inc., and other institutions in the United States and Canada.
However, Little and coauthors found evidence suggesting that the actual rate of transmitted resistance is considerably higher and rising, a trend which could reduce the overall efficacy of antiretroviral treatment.
The researchers reviewed data from 202 patients who first began treatment between 1995 and 2000. The prevalence of infections refractory to treatment with at least one antiretroviral agent was 3.4% during the first 3 years of that period, they said, with just over 1% of new patients carrying infections resistant to multiple drugs.
However, the frequency of drug resistant strains had risen to more than 12% by the year 2000, study data showed, while more than 6% of treatment-naive patients demonstrated multidrug resistance at this time. Moreover, the rate of new cases carrying mutations linked to drug resistance jumped from 8% to more than 22% between 1995 and 2000, as the frequency of multidrug-resistance mutations in new patients rose from 3.8% to 10.2%.
Not surprisingly, antiretroviral treatment was significantly less effective for patients infected with drug-resistant HIV varients (Antiretroviral-drug sesistance among patients recently infected with HIV. N Engl J Med 2002 Aug 8;347(6):385-94.
"The proportion of new HIV infections that involve drug-resistant virus is increasing in North America," Little and colleagues concluded. "Testing for resistance to drugs before therapy begins is now indicated even for recently infected patients."
The corresponding author for this report is Susan J. Little, University of California at San Diego, Antiviral Research Center, Dept. of Medicine, 150 W. Washington St., San Diego, CA 92103, USA.
A search at www.NewsRx.net using the search term "AIDS and HIV therapy" yielded 1193 articles in 29 specialized reports.
Key points reported in this study include:
This article was prepared by AIDS Weekly editors from staff and other reports.
Reference
Little SJ, Holte S, Routy JP, et. al., "Antiretroviral-drug resistance among patients recently infected with HIV", N Engl J Med 2002 Aug 8;347(6):385-94
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