Incidence of Drug-Resistant HIV Strains May Increase in Africa With Increased Availability of Antiretroviral Drugs

The increased availability of antiretroviral drugs in African countries with high HIV/AIDS prevalence rates may result in more drug-resistant HIV strains, the San Francisco Chronicle reports. National HIV/AIDS treatment programs, such as the one being developed in South Africa, and international aid for the provision of medicines to treat the disease cannot afford to downplay the risk of the development of multiple drug-resistant strains of HIV, Dr. Robert Gallo, a co-discoverer of HIV, said in July at an international AIDS conference. Gallo said in an interview with the Chronicle that providing unrestricted access to antiretroviral drugs could cause "multiple drug-resistant mutants of HIV which become epidemic and cause new kinds of epidemics in the future." HIV is "notoriously quick" to mutate when challenged by drugs, and the appearance of resistant strains is "sounding an alarm" in the medical community, according to the Chronicle. Studies have shown that 10% to 15% of all new HIV infections in the United States and Europe are resistant to some of the drugs.

Treatment Benefits
Although the cost of providing antiretrovirals in developing countries has fallen due to the production of generic drugs and donations from drug companies, the detection and treatment of people with drug-resistant HIV strains is much more expensive, according to the Chronicle. In addition, the delivery process for antiretrovirals in Africa is "chaotic," and the continent is "ripe" for developing mutated HIV strains, the Chronicle reports. Dr. Robert Grant, an assistant professor of medicine at the University of California-San Francisco, said that concerns of resistance should not cause people to lose sight of the "more important outcomes [of providing antiretrovirals] -- prolonging of life, relief of suffering, improved productivity and decrease in transmission." Gallo said that African countries need to invest in health care infrastructure such as training for medical personnel, developing treatment support mechanisms and doing research on the effect of administering the drugs to "head off a disaster," according to the Chronicle (du Venage, San Francisco Chronicle, 8/29).

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