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

For example, the death rate from AIDS dropped 47 percent in the United States between 1996 and 1997. Scientists have been concerned, however, that the success of antiretroviral drugs has resulted in the increased transmission of drug-resistant strains of the virus.

To measure the prevalence of this resistance, the researchers performed genetic analysis on virus in blood drawn from 80 patients to find any HIV mutations associated with drug resistance. They found that 13 of the patients, or 16.3 percent of the total, carried strains that were less susceptible to an antiretroviral drug by a factor of three or more. The scientists said the actual percentage of patients carrying resistant strains in the group is probably higher because other mutations that confer resistance have not yet been identified. Viruses resistant to more than one drug were found in only 3 patients, constituting 3.8 percent of the total.

"Rather than jumping to any conclusions about whether resistant strains of HIV are being widely spread, we need to measure the resistance in other populations," says study co-author Martin Markowitz, M.D. "If it appears that HIV resistance to drugs is becoming more common in the future, we may have to alter current strategies for treatment. But until we know more, we do not want patients to stop taking drugs because in most cases they are quite effective." The scientists recommend initiation of clinical trials to determine whether therapy guided by resistance testing would work better than issuing the standard drug or combination of drugs. Such testing might lead to drug therapies tailored around the specific resistant HIV strain found in a particular patient.

Boden's and Markowitz's co-authors are Arlene Hurley, R.N., Linqi Zhang, Ph.D., Yunzhen Cao, M.D., Yong Guo, M.S. Elizabeth Jones, B.A., John Tsay, B.A., James Ip, B.A., of the Aaron Diamond Aids Research Center at Rockefeller University, Charles Farthing, M.D., of

Contact: Jim Stallard
Rockefeller University

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