1st
appeared 1 July 1998
Transmission
of Protease-Resistant Strain of HIV Documented
A team of AIDS
researchers has reported a case in which a person
has become infected with a strain of HIV that is
resistant to six of the 11 approved HIV
anti-retroviral drugs, including protease
inhibitors. Transmission of drug-resistant HIV
has been reported previously, but only to
anti-retrovirals known as reverse transcriptase
inhibitors, which work by blocking the
replication of the virus. They have been in use
for more than 10 years, but are less effective
treatments.
The
transmission of protease inhibitor resistant
strains of HIV to a previously uninfected person
could represent an emerging clinical and public
health problem because protease inhibitors are a
powerful weapon in the arsenal against HIV, said
Frederick Hecht, assistant clinical professor of
medicine at SFGH, and lead author of the study.
The case study
was reported by Hecht today (July 1) at the 12th
World AIDS Conference in Geneva. Research results
also will be published in the New England Journal
of Medicine, currently in press. The
investigators are from the UCSF AIDS Research
Institute, ViroLogic, Inc., and the Centers for
Disease Control and Prevention.
The subject of
the case study was a middle-aged homosexual man
who reported that his only risk encounter in the
six months prior to being infected with HIV was
receptive anal intercourse without a condom. He
said his partner had withdrawn before
ejaculation, a behavior that many in the gay
community have considered to be a low-risk
practice. Hecht said that interruptions in the
man's partner's treatment may have contributed to
the development of resistant HIV that was
transmitted to the patient.
"This
study shows that we can do more harm than good if
we don't help patients take their medications
correctly," said Margaret Chesney, professor
of medicine at UCSF, a co-investigator of the
study, and an expert on adherence issues.
"The bottom line is that helping patients
stick to these difficult regimens is as important
as the drugs themselves."
"We still
don't know how frequently resistant strains are
transmitted," Hecht said. "But we now
know that people can acquire strains with
multi-drug resistance, including resistance to
protease inhibitor treatment."
source: Mitzi Baker, News
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Today's
UCSF reports from the World AIDS Conference Despite
Multiple Exposures, Some Remain Uninfected by HIV
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Resistant Strain of HIV Documented
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Prevented with Expanded Medicaid Coverage
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