HIV May Develop Resistance Against Wonder Drug

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The present study was conducted by an international team of researchers from South Africa, the UK, and the USA, who examined the genetic code of HIV to determine if drug resistance mutations in 874 volunteers living with HIV affected their treatment success. The individuals were enrolled in a clinical trial for people initiating HIV treatment to compare two-drug regimens: efavirenz, an NNRTI and prior first-line therapy in the region, and dolutegravir.

Unexpectedly drug resistance was observed with patients taking Dolutegravir too. “We fully expected efavirenz to be less effective among patient’s HIV strains resistant to NNRTIs. What took us completely by surprise was that dolutegravir – a different class of drug which is generally effective in the face of drug resistance – would also be less effective in people with these resistant strains. We are working now to tease out if this was due to the virus or the participants – for instance, if people with resistance are less likely to take their pills regularly. Either way, if this pattern holds true, it could have far-reaching impacts on our predictions of long-term treatment control for millions of people taking dolutegravir in the region”, said Dr. Mark Siedner, a faculty member at the Africa Health Research Institute in KwaZulu-Natal, South Africa and Massachusetts General Hospital in Boston, Massachusetts.

Though the exact mechanism why efavirenz-resistant mutations should affect the susceptibility of dolutegravir was not clear, further research is being dedicated to explore the efficacy of the treatment. The study highlights the urgent need for prioritizing point of care tests to identify people with drug resistance HIVand accurately monitor treatment adherence.

Source: Medindia

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