More Than One-Quarter of Newly Infected HIV-Positive San Franciscans Infected With Drug-Resistant HIV Strain, Study Says
At least 25% of newly infected HIV-positive San Franciscans are infected with a strain that is resistant to at least one of the three most commonly prescribed AIDS drugs, according to a University of California-San Francisco study, the Los Angeles Times reports. The study will be published in the July 10 issue of the Journal of the American Medical Association but was released early to coincide with the XIV International AIDS Conference in Barcelona, Spain. UCSF researcher Dr. Frederick Hecht and colleagues studied 225 newly infected patients between 1995 and 2001, using "at least" two different drug resistance tests. Researchers used the "stringent" criterion that a resistant virus tolerate 10 times a drug's normal dose. The researchers found that in 2001, 21% of the patients had viruses resistant to reverse transcriptase inhibitors, 13% had viruses resistant to non-nucleoside reverse transcriptase inhibitors and 7% had viruses resistant to protease inhibitors. Thirteen percent of the patients were resistant to two or more of the drugs and one patient was resistant to all three classes of drugs. Overall, 27.4% of the patients studied had viruses resistant to at least one of the drugs. In addition, patients with a resistant virus strain required a 12-week treatment regimen with another drug to reduce the virus to undetectable levels, compared to a four-week regimen for patients without resistant virus (Maugh, Los Angeles Times, 7/7). The study results "cast doubt" on how long the effectiveness of AIDS combination therapy will last, Newsday reports (Garrett, Newsday, 7/6). The study also found that the resistant-virus strains are being transmitted to others by HIV-positive patients currently receiving AIDS drugs, in whom the virus "is evolving ways to sidestep medicines targeted against it" (Russell, San Francisco Chronicle, 7/7). According to the Times, HIV/AIDS trends that surface in San Francisco often appear in other geographical locations "a few months or years later" (Los Angeles Times, 7/7). "There has been a decrease in caution about avoiding HIV infection and an increase in riskier sexual behavior ... on the assumption that HIV is much (more) readily treated now," Hecht said, adding, "That idea needs to be called into question because some people are becoming infected with (a strain of) virus that is going to be much more difficult to treat" (Hirschler, Reuters/Washington Times, 7/7).
HAART Safe for Those with Hepatitis C
People with both hepatitis C and HIV can be "safely" treated for HIV, according to a Johns Hopkins University School of Medicine study also to be published in the July 10 issue of JAMA, the Los Angeles Times reports (Los Angeles Times, 7/7). Lead author Dr. Mark Sulkowski studied 1,995 HIV-positive patients, 45% of whom also had hepatitis C infection and none of whom had AIDS, who were enrolled at the Moore HIV Clinic of the Johns Hopkins Hospital from January 1995 to January 2001. Although patients with both hepatitis C and HIV are less likely to receive highly active antiretroviral treatment for their HIV infection, such patients do "just as well" on the treatment regimen as those without hepatitis C, researchers found. According to the study, hepatitis C "does not increase the risk of death, accelerate the development of AIDS or curb the value of antiretroviral HIV therapy." Sulkowski added, "Hepatitis C virus infection should not be a barrier to aggressive antiretroviral therapy in HIV patients." According to the Associated Press, 16% to 30% of HIV-positive individuals in the United States and Europe are co-infected with hepatitis C (Associated Press, 7/7).