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Failure Much More Likely in Transmitted Drug-Resistant HIV

Antiretroviral-naive patients with TDR disease three times more likely to have treatment failure

MONDAY, Feb. 28 (HealthDay News) -- A substantial portion of antiretroviral-naive patients are infected with transmitted drug-resistant HIV with one or more drug-resistant mutations, and they are much more likely to experience treatment failure, according to research published online Feb. 28 in The Lancet Infectious Diseases.

Linda Wittkop, M.D., of the University Bordeaux Segalen in France, and colleagues enrolled 10,056 patients who had started combination antiretroviral therapy (cART) and had undergone genotypic testing for drug resistant mutation to study the effect of transmitted drug resistance (TDR) on cART.

The researchers found that 475 patients (4.7 percent) had at least one mutation but received fully active cART, 479 (4.8 percent) had at least one mutation and resistance to one or more drug, and the remaining 9,102 patients (90.5 percent) had HIV without TDR. Estimated virological failure at 12 months was 4.2 percent for the HIV without TDR group, 4.7 percent for the TDR and full cART group, and 15.1 percent in those with at least one mutation and TDR.

"These findings confirm present treatment guidelines for HIV, which state that the initial treatment choice should be based on resistance testing in treatment-naive patients," the authors write.

Several authors disclosed financial relationships with pharmaceutical companies.

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