At Least Half of HIV-Positive Patients on Antiretroviral Treatment Develop Drug Resistance Due to ‘Widespread Misuse,’ Survey Says
At least 50% of HIV-positive people who receive antiretroviral drug treatment in the United States have developed resistance to their drugs because of "[w]idespread misuse" of the medicines, according to a new national survey by RAND Corp. in Santa Monica, Calif., and the University of California-San Diego. The study, which will be presented today at the annual Interscience Conference on Antibacterial Agents and Chemotherapy in Chicago, Ill., tracked approximately 2,000 people undergoing highly active antiretroviral therapy (HAART) and measured their blood viral levels to determine whether their drugs remained equally effective over time. According to Newsday, the study found that 64% of participants experienced a rise in viral levels over time, indicating that they are now receiving "less benefit from their drug cocktails" than they were two or three years ago. Researchers found that 78% of the patients who had exhibited rising viral levels had also developed drug-resistant strains of HIV. In addition, the study found that 20% of people who were newly infected with HIV and had not yet taken antiretrovirals were already carrying drug-resistant strains of the virus that they contracted from a sexual partner or through intravenous drug use. Study co-author Dr. Doug Richman of UCSD said that "conservative" estimates based on the study data indicate that approximately 50% of people undergoing antiretroviral treatment in the United States currently carry drug-resistant HIV strains. Richman said that many doctors and patients frequently switch drug regimens "in a never-ending search for minimal side effects, ease of use and viral suppression," and this "chaotic use" of antiretrovirals has led to a rise in "mutant HIVs" that can resist the drugs. Richman added that pharmaceutical companies do not have much incentive to develop drugs that target drug-resistant HIV because the population of HIV-positive people in developed countries is fairly small. Newsday reports that the study findings "be[g] the question of just how much longer the HAART miracle ... will last" (Garrett, Newsday, 12/18).This is part of the KHN Morning Briefing, a summary of health policy coverage from major news organizations. Sign up for an email subscription.