AIDS CONFERENCE: Some Patients Now Immune To Protease Inhibitors
Researchers at the 12th Annual World AIDS Conference yesterday confirmed a development that many had long feared: strains of HIV are now being detected that are resistant to the most advanced drugs from the moment of infection. "Researchers have long known that HIV, which causes AIDS, can lose susceptibility to any drug in any given patient," the Boston Globe reports. What has researchers alarmed "is that the multidrug-resistant strains, and those that have escaped the effects of protease and nucleoside drugs alone, have been passed from one individual to another" (Knox, 7/1). "We may be seeing an emerging and dangerous edge to the epidemic," said Dr. Frederick Hecht of the University of California-San Francisco. Hecht reported to the conference the case of a patient who was "resistant to all four of the protease inhibitors now in use, as well as to two older, widely used AIDS drugs, AZT and 3TC." The man's partner apparently was treated with nine different AIDS drugs since 1990, but used them only sporadically, thus building up immunity. Researchers at the University of Geneva found similar strains of HIV in six of 57 patients (Perlman, San Francisco Chronicle, 7/1).
A Step Back?
NPR's Brenda Wilson reported, "For many public health officials, this case emphasizes the danger of becoming complacent about HIV and AIDS, of engaging in practices that appear to be safe, but aren't. Compliance with treatment, no matter how difficult, is essential, and sexual intercourse is still safer using a condom." Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said, "That really is a wake-up call for people who are assuming that since we have what appears to be adequate therapy, that if they get infected now, that they'll be able to easily treat their infection. If you happen to get infected from a person who has a multiple drug-resistant virus, it's just as if you got infected in 1983 when we had absolutely no anti-retroviral drugs" ("Morning Edition," 7/1). Some doctors, however, cautioned against panicking. Dr. David Ho of the Aaron Diamond AIDS Research Center said, "So, it's happening, but it's rare, and it would be wrong to say that this is ... a rampant phenomenon. It's not, but it's the beginning, I think." Tom Coats of UCSF said, "This is a real problem and this has happened before with other infectious diseases. It's happened with tuberculosis. We know it's happened with gonorrhea" (CNN, "World Today", 6/30).