Since catching treatment failure early is key to preventing further resistance, this research, published in the Feb. 1 issue of Clinical Infectious Diseases and currently available online, also argues for greater access in the developing world to tests that detect when the amount of virus in a patient's blood is increasing.
Combined antiretroviral therapy has dramatically changed the course of HIV disease, with a substantial reduction in illness and death both in developed and in developing nations. In Thailand, where a 2004 estimate put the number of HIV-infected people at 600,000, a generic, fixed-dose, combined pill of three antiretroviral agents has been available since 2002. In 2004, it was estimated that 60,000 Thai citizens would take this combination of stavudine, lamivudine, and nevirapine, known as d4T/3TC/NVP.
Lead author Somnuek Sungkanurparph, MD, of Ramathibodi Hospital in Thailand, and co-authors found that when this combination stopped working, it was nearly always because the virus had developed mutations that also make useless several other drugs of the same type.
Ideally, if a patient developed resistance to one or more of the elements in d4T/3TC/NVP, then he or she would simply switch to a different combination of drugs. However, in Thailand and other resource-limited countries, economics often determines what types of drugs are available. Some drugs that, in a developed country, might serve as a second regimen are either unaffordable or unavailable.
A small number of drugs do exist that are available and affordable in Thailand and that could serve as a second regimen--if the drug-resistant virus is caught before it gets out of hand. Dr. Sungkanurparph found that when levels of virus in patients' blood were high, nearly two-thirds of them developed multiple drug resistance that limited the options for second-line therapy. When levels were low, only about one-third did.
Unfortunately, the test to detect how much virus is in a patient's blood is not widely available or affordable in many developing countries. Without this tool, which allows early detection of treatment failure, physicians can not change antiretroviral medications in time to stay ahead of resistance. In order to prevent sickness and death from HIV in developing countries, the accessibility of both ART and the virus-detection test need to be increased.
"In settings where antiretroviral agents are limited, prevention strategies for HIV resistance are crucial," said Dr. Sungkanurparph. "Early detection of virological failure provides more options for the second regimen and better treatment outcomes."
Steve Baragona | EurekAlert!
Diagnoses: When Are Several Opinions Better Than One?
19.07.2016 | Max-Planck-Institut für Bildungsforschung
High in calories and low in nutrients when adolescents share pictures of food online
07.04.2016 | University of Gothenburg
Terahertz excitation of selected crystal vibrations leads to an effective magnetic field that drives coherent spin motion
Controlling functional properties by light is one of the grand goals in modern condensed matter physics and materials science. A new study now demonstrates how...
Researchers from the Institute for Quantum Computing (IQC) at the University of Waterloo led the development of a new extensible wiring technique capable of controlling superconducting quantum bits, representing a significant step towards to the realization of a scalable quantum computer.
"The quantum socket is a wiring method that uses three-dimensional wires based on spring-loaded pins to address individual qubits," said Jeremy Béjanin, a PhD...
In a paper in Scientific Reports, a research team at Worcester Polytechnic Institute describes a novel light-activated phenomenon that could become the basis for applications as diverse as microscopic robotic grippers and more efficient solar cells.
A research team at Worcester Polytechnic Institute (WPI) has developed a revolutionary, light-activated semiconductor nanocomposite material that can be used...
By forcefully embedding two silicon atoms in a diamond matrix, Sandia researchers have demonstrated for the first time on a single chip all the components needed to create a quantum bridge to link quantum computers together.
"People have already built small quantum computers," says Sandia researcher Ryan Camacho. "Maybe the first useful one won't be a single giant quantum computer...
COMPAMED has become the leading international marketplace for suppliers of medical manufacturing. The trade fair, which takes place every November and is co-located to MEDICA in Dusseldorf, has been steadily growing over the past years and shows that medical technology remains a rapidly growing market.
In 2016, the joint pavilion by the IVAM Microtechnology Network, the Product Market “High-tech for Medical Devices”, will be located in Hall 8a again and will...
14.10.2016 | Event News
14.10.2016 | Event News
12.10.2016 | Event News
24.10.2016 | Earth Sciences
24.10.2016 | Life Sciences
24.10.2016 | Physics and Astronomy