Primary resistance to anti-HIV drugs increasing in the UK
Patients in the UK have one of the highest rates of primary (transmitted)
resistance to anti-HIV drugs in the world, a BMJ study has revealed,
raising concerns that this could lead to a second-wave epidemic of
drug-resistant HIV.
Using national data on 2,357 HIV-positive patients who had not yet received
treatment, researchers found a 14 per cent rate of resistance to one
or more antiretroviral drugs. This was higher than the primary resistance
rates of 7 per cent, 6 per cent and 10 per cent in the US, France and
the rest of Europe,
respectively.
The researchers, from the UK group on transmitted HIV resistance, identified
335 patients whose viruses had changes that made them resistant to one
or more antiretroviral drugs. Of these, 257 patients were resistant to
drugs within one drug class only, 44 cases showed resistance to drugs
within two drug classes and 34 showed resistance to drugs within all
three commonly used drug classes (non-nucleoside reverse transcriptase
inhibitors [NNRTIs], nucleoside or nucleotide reverse transcriptase inhibitors
and protease inhibitors). Resistance to NNRTIs showed the sharpest increase.
“
By limiting the therapeutic options for a significant number of patients,
the secondary epidemic of drug-resistant HIV represents a major clinical
and public health problem,” the authors conclude.
Commenting on the study, Annette Fitzsimons, specialist HIV pharmacist,
Royal South Hants Hospital, Southampton, said: “It is not surprising
that resistance to NNRTIs has shown the sharpest increase, because this
is one of the first-line recommendations from the British HIV Association.”
Deenan Pillay, head of research, HIV/STI and blood-borne viruses, Centre
for Infections, Health Protection Agency, and one of the study authors,
said that since transmitted drug-resistant viruses have originated in
individuals receiving therapy (and who therefore know they are infected),
the study findings underline the importance of health education messages
on safe sexual practices.
The study was published online by BMJ Online First on 18 November. |
The
Pharmaceutical Journal
Acrobat
Reader