NEW YORK (Reuters Health) - HIV genotyping before the initiation of antiretroviral therapy in patients with HIV infection could identify a considerable proportion with mutations associated with drug resistance, researchers report in the June 15th issue of the Journal of Infectious Diseases.
This is of consequence, lead author Dr. Hillard S. Weinstock told Reuters Health, because, “the first drug regimen is the most important for patients infected with HIV.”
Dr. Weinstock of the Centers for Disease Control and Prevention, Atlanta and colleagues note that the prevalence and characteristics of infections in such patients “have not been well described.”
To investigate, the researchers conducted a multicenter study of patients, who over a 1-year period, were diagnosed with HIV infection but had not progressed to AIDS.
In all, 1082 were genotyped. Of these, 8.3% had reverse transcriptase or major protease mutations associated with reduced susceptibility to antiretroviral drugs.
The prevalence was 11.6% in men who had sex with men, 4.7% in heterosexual men and 6.1% in women. Whites had the highest ethnicity-associated prevalence (13.0%), followed by Hispanics (7.9%) and African Americans (5.4%). In patients whose partners reportedly took antiretroviral drugs, the prevalence was 15.2%.
The researchers conclude that testing prior to therapy “would identify a substantial number of infected persons” with drug-resistant mutations. Genotyping may also “be beneficial to the patients and cost effective.”
Dr. Weinstock added that, “we must continue to monitor antiretroviral drug resistance in large populations to detect changes over time in the prevalence of these mutations and the groups of infected persons affected.”
Source: J Infect Dis 2004;189:2174-2180. [ Google search on this article ]
MeSH Headings: Community Health Services : Data Collection : Diagnosis : Diagnostic Services : Environment and Public Health : Epidemiologic Methods : Health Care Facilities, Manpower, and Services : Genetic Screening : Health : Health Occupations : Health Services : Health Services Administration : Health Surveys : Information Science : Mass Screening : Medicine : Investigative Techniques : Population Characteristics : Preventive Health Services : Preventive Medicine : Public Health : Quality of Health Care : Specialties, Medical : Public Health Practice : Health Care Quality, Access, and Evaluation : Health Care Evaluation Mechanisms : Diagnostic Techniques and Procedures : Analytical, Diagnostic and Therapeutic Techniques and Equipment : Biological Sciences : Health Care : Information Science
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