Hi Dr. D,

I just came back from getting a vaccination at the dr.'s office and the nurse there told me that since September 2006, they've gotten eight (8) new HIV patients who have been resistant to all available medications. And the kicker is that all these folks are under 26. She said they're on some kind of waiting list for 3 new drugs coming out next year.

Anyway, I just wanted to know is there some type of agent under investigation or in the pipeline to which HIV could not become resistant? Maybe something that attacks it in some novel way against which it would have no defense?

Thank you for your post.

You bring up an important issue and ask a great question.

First of all, it is known that some individuals are infected by strains that are already resistant to currently available medications. Less commonly people have acquired virus that is resistant to multiple drugs. It is for this reason that it is generally recommended that people have drug resistance testing performed prior to starting therapy for the first time.

With regards to drugs being developed for which resistance will not develop. I only wish. Thus far resistance has been shown to develop to all drugs that have ever been shown to have activity against HIV. Nevertheless, for those that achieve undetectable levels of virus on combination therapy there does not appear to be any development of resistance. Consequently, this goal of therapy remains now, and likely in the future to be very important for sustained responses to treatment.

Best, Eric