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African HIV strains appear more resistant to current therapies

Of the 40 million people infected worldwide with HIV, more than 70 percent live in Africa. Yet a new study suggests a key component in current therapies could be less effective on African forms of the virus. The findings are reported in the July 9 print issue of Biochemistry, a peer-reviewed journal of the American Chemical Society, the world's largest scientific society.

"Although clinical studies are still very limited, early reports in the medical literature have suggested a poorer long-term response to antiviral therapies in African patients, despite a similar initial response," said Ernesto Freire, Ph.D., professor of biology and biophysics at Johns Hopkins University and lead author of the paper.

One proposed explanation for the response has been patients' inability to adhere to the strict regimen required by antiretroviral drugs. But the new studies also suggest a molecular basis might be present.

HIV's shape-shifting nature has helped it reach epidemic proportions. The virus constantly morphs, causing drug resistance and geographical variations. For example, the HIV-B subtype predominates in Western Europe and the United States, while genetically different strains HIV-A and HIV-C occur mostly in Africa. Currently available therapies have been designed specifically for the B subtype, Freire said, but now may need to be tailored for the African subtypes.

Some of the most effective weapons in the fight against HIV infection are protease inhibitors. These compounds are not AIDS vaccines, but can reduce the spread of the disease by binding to the HIV protease a key protein in the reproductive cycle of the virus.

In their study, the researchers introduced into the C and A proteases a common B-subtype mutation that could potentially be seen in African forms of the virus. The mutations, known to cause drug resistance in the B-subtype, enhance the biochemical "fitness" of the protease, making it better able to survi
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Contact: Beverly Hassell
b_hassell@acs.org
202-872-4065
American Chemical Society
3-Jul-2002


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