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Drug resistance a major setback to fight

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Resistance to common HIV drugs could threaten the fight against the disease

Resistance to common HIV drugs could allow the virus to mutate. File picture

More and more countries are reaching the “threshold” of resistance to the most commonly-used HIV drugs which could “undermine global progress in treating and preventing HIV”, according to the World Health Organisation (WHO).

HIV drug resistance occurs when individuals do not take their medicines as prescribed. This gives the virus a chance to mutate to the point where the medication no longer works to suppress the virus – allowing it to multiply and make a person open to infections that can make them sick.

When HIV activist Prudence Mabele died, her CD4 count was only 14, although she had been on ARVs for many years. Veteran HIV activist Zackie Achmat revealed over the weekend that Mabele “regularly joked that she interrupted her antiretroviral treatment”.

“‘Treatment holidays’ are dangerous and most probably were the cause of her premature death,” said Achmat.

The WHO recommends that when 10% of people on the first-line drug regimen become resistant, this could threaten the fight against HIV and countries should switch to a different first-line regimen.

Threshold

Six out of 11 countries surveyed in Africa, Asia and Latin America have reached this threshold and should change their first line regimen, according to a WHO report released last week.

“We would like to raise attention to the problem and we would like more data to see if it’s a generalised problem in the African context and other contexts. And we think it is – because if we look at not only WHO surveillance data but also from other research, we are seeing resistance has reached the 10% level,” the WHO’s Dr Silvia Bertagnolio told Health-e News from the International Aids Society (IAS) Conference on HIV Science in Paris.

While the report does not include national data from South Africa, Professor Francois Venter from the Wits Reproductive Health and HIV Institute said that reports from around the country indicate we have also surpassed this 10% threshold.

According to the WHO’s Dr Meg Doherty, up to 40% of South African patients who stopped taking their ARVs only resumed treatment when they were very sick and “are more likely to die if we don’t intervene very quickly”.