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Re resistance study findings
Feb 17, 2002

Thank you for your thoughts on the resistance study findings.

I have also asked my doctor about the study and he pointed out that the study would necessarily involve a skewed population in that to participate one would have to be someone with resistance. Because a significant amount of resistant virus (about 1000 copies) must be present before it can be tested, the study could not be a study of all on therapy, in other words. He suggested that the study added nothing new to what we already know (ie, that for various reasons a proportion of those on therapy develop resistance).

This analysis makes sense to me. Would you agree with it?

Response from Dr. Little

I am presuming that you are referring to the study presented by Dr. Richman on behalf of the HCSUS group? This study is not in any way skewed - on the contrary, this study went to great lengths to avoid just this. What they did was to assess the prevalence of resistance among those with detectable viral loads - they assumed (very conservatively) that those with undetectable viral loads had no resistance. So, I believe that this study provides a conservative estimate of resistance in the general population. Although many have long suspected that resistance rates were high, this study provides a number for the amount of resistance and makes it clear that this problem is not going to be overcome easily. I do not think it spells doom and gloom for people on therapy and doing well - this was not the intention of the study. It was to provide the best possible assessment of drug resistance in the general US population.


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