Reduced Antiretroviral Drug Susceptibility Among Patients With Primary HIV Infection

Open Access
Publisher Website
Google Scholar
Abstract
Antiretroviral (ARV) drug resistance is associated with diminished responses to treatment1-3 and increased mortality3,4 in patients with established human immunodeficiency virus (HIV) infection. The transmission of single drug–resistant5,6 and multidrug-resistant7,8 virus has been documented, although the overall frequency of these events in the United States is unknown. Persistent viral replication (plasma HIV RNA >500 copies/mL) is observed in 10% to 40% of therapy-naive subjects with established infection treated for 24 weeks with potent ARV therapy.9-11 More widespread use of these potent regimens among infected patients at both early and later stages of infection12 may increase the number of individuals in whom drug resistance is selected during therapy and perhaps increase the population-based risk for transmission of resistant HIV. Furthermore, the use of a suboptimal initial treatment regimen in a person infected with drug-resistant virus is expected to limit the magnitude and durability of an antiviral response and may preclude the preservation of HIV-specific immune responses associated with early, effective ARV therapy.13 Prospective studies are needed to evaluate the clinical significance of primary HIV infection with drug-resistant virus and the subsequent virological response to ARV therapy.

This publication has 23 references indexed in Scilit: