HIV drugs failing in Africa

2011-03-12 00:00

AFRICAN countries need to take steps to monitor and prevent the spread of drug-resistant HIV. This is the warning from researchers at an annual conference on retroviruses in Boston.

Evidence presented to the conference showed that people who have never taken antiretroviral (ARV) medicine are increasingly being infected with HIV that is resistant to common ARVs.

They were probably infected by people who had either stopped taking ARVs or their ARV treatment had failed.

Countries where ARV programmes have been running for a long time are most likely to report drug-resistant HIV.

In parts of Brazil almost 20% of people tested have HIV that is resistant to at least one ARV.

In a study of almost 2 500 people in six African countries, drug resistance was highest in Uganda, which introduced ARVs earlier than the other countries surveyed, including South Africa and Nigeria.

At three Ugandan sites, almost 12% of people who had never been on ARVs before were infected with drug-resistant HIV.

Uganda was one of the first African countries to introduce ARVs, but in the mid-1990s some people were treated with one or two ARVs due to of the high costs.

As the HI virus mutates easily, three different ARVs need to be taken at the same time every day for the patient’s entire life to prevent drug-resistant HIV mutations.

In Uganda, there was most resistance to nevirapine and efavirenz, two of the most common antiretrovirals used in Africa.

Nevirapine has also been used for many years to prevent mothers from infecting their children with HIV.

PharmAccess, which conducted the African study, estimates that the risk of resistance increased by 38% for each year of ARV provision.

PharmAccess’s Dr Raph Hamers also reported on a study of young, newly infected Ugandans conducted last year that showed that over eight percent had drug-resistant HIV.

A World Health Organisation survey identified a number of factors that could drive the spread of drug-resistant HIV in Africa, including patients dropping out of ARV programmes, picking up their medication late and clinics running out of ARVs.

 

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