Rockefeller and Aaron Diamond researchers say resistance to HIV drugs may be higher than previously thought

Scientists Say Widespread Analysis of Virus Strains Should Guide AIDS Therapy

A study of patients infected with the AIDS virus revealed that about one in six was carrying a strain that is resistant to at least one of the drugs targeting HIV, researchers report from the Aaron Diamond AIDS Research Center, an affiliate of The Rockefeller University. Lead author Daniel Boden, M.D., and 11 colleagues report the research as the cover story in the Sept. 22-29 issue of the Journal of the American Medical Association. The authors suggest that further research should try to establish whether AIDS therapy structured around HIV-resistance testing would be more effective than current methods.

Although the researchers caution that the analysis was limited to a subset of the AIDS population -- mostly gay, white men who were recently infected -- the percentage of patients in the group carrying a resistant strain was significant. The researchers found that viruses resistant to more than one drug were much less common.

"There are two important messages we should draw from this study," Boden says. "First, that we need to explore how widespread this resistance is. Is the percentage going to be the same in the AIDS population in general? Is it affected at all by means of transmission? The second message is that HIV has a much tougher time resisting three drugs than one. Until we know how much resistance there is and what is causing it, we recommend that infected patients who are able to should follow the multidrug therapy."

The study is the first to be published that attempts to measure the prevalence of transmitted drug-resistant HIV-1 in the United States during the era of combination anti-retroviral therapy. Since it was implemented four years ago, the multidrug approach -- in which infected patients take a combination of drugs (usually three) every day -- has caused a marked reduction in AIDS cases and AIDS deaths.

Contact: Jim Stallard
Rockefeller University

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