‘Superbugs’ Resisting AIDS Drugs
As many as one in seven people contracting HIV-AIDS today are being infected with "superbugs" that are resistant to many medications, according to new research.
"Some people are going to become infected with a virus that might not be impossible, but will be more difficult to treat," said Frederick Hecht, Research Director at the Osher Center for Integrative Medicine at the University of California, San Francisco.
The research has been published in in June, 2002, the Journal of the American Medical Association. It was released to coincide with the opening of the 14th International Conference on AIDS in Barcelona.
According to a study, the number of people known to have contracted resistant strains of HIV-AIDS has quadrupled since 1996. Many are resistant to two of three major classes of drugs available today.
Ironically, the troubling trend is directly linked to the widespread availability of life-prolonging drug cocktails. The complex regimes need to be followed to the letter, or the virus can mutate and become resistant, creating strains of the disease far more difficult to treat.
Dr. Hecht said resistant strains are spread for a number of reasons. Some people infected with HIV-AIDS, such as intravenous drug users, have difficulty respecting a strict regime. A number of myths, such as the belief that people taking the drug cocktails cannot spread the disease, are also contributing to the problem.
The research was conducted on 225 San Franciscans who had been diagnosed with HIV in 2001, but the authors said the findings are indicative of trends in areas where the cocktails are widely used.
The researchers said that all newly diagnosed patients should be tested for resistance. "Our data support the use of resistance testing in recently infected persons in settings where antiretroviral use is widespread," the researchers said.
This would ensure patients are not treated needlessly with drugs that do not work, and could help stem the spread of resistant strains.
In an editorial published in the same edition of JAMA, Joel Trachtenberg of the University of Utah in Salt Lake City, said the real danger from resistance is in the developing world.
Cocktails are only becoming available in many countries hard-hit by HIV-AIDS, and widespread resistance would leave sufferers without treatment again. Newer drugs are considerably more ex-pensive, according to the authors.
Among The Findings in The JAMA Research:
Resistance to the class of drugs called non-nucleoside reverse transcriptase inhibitors increased to 13.2 per cent in 2000-2001 from 0 per cent in 1996-97; these drugs, which work to block the virus from replicating, were the first to be available.
Resistance to the class of drugs called protease inhibitors rose to 7.7 per cent from 2.5 per cent in the same period; they block an HIV enzyme and have been credited with the big declines in deaths among people with HIV.
Resistance to the class of drugs called nucleoside reverse transcriptase inhibitors decreased to 6.2 per cent from 21 per cent; these drugs also block the virus from replicating and are always used in combination with one or both of the other drugs.
The number of newly infected in the study resistant to two or more classes of drugs rose to 13 per cent from 3 per cent.
Only one of the 225 patients was resistant to all three classes of drugs.
In June, 2002, UNAIDS released data showing that 730,000 people worldwide are being treated with drug cocktails.
However, more than 500,000 of the patients live in wealthy countries where, in total, there were 25,000 deaths in 2001.
By contrast, only 30,000 people infected with HIV-AIDS are receiving drug cocktails in all of Africa, where there were 2.2 million deaths last year.
UNAIDS estimates that at least six million people in the developing world could benefit from the cocktails.
Andre Picard, Public Health Reporter is a reporter at the Globe & Mail, Toronto.
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