United Kingdom: Alarm Over HIV Resistance

The annual conference of the Public Health Laboratory Service (PHLS) heard this week that one in four new HIV infections in the United Kingdom might be resistant to current drug treatments. According to the officials, the growing problem of resistance makes measures to prevent initial HIV infection even more important.

Dr. Deenan Pillay of the PHLS Antiviral Susceptibility Reference Unit in Birmingham told the conference that experts had long suspected HIV patients might begin to develop resistance to drugs after they had been receiving treatment for some time. "However, we now know that resistant strains can be transmitted from one person to another, meaning that patients can be carrying drug-resistant strains from the moment they are infected," he said. "This does not mean that they cannot be treated, but it does mean that the range of drugs available to treat them is reduced," he added.

Referring to a study of five patients, Pillay said that resistance, once established, appeared to remain in most cases. Among the five patients infected with resistant HIV, the resistant element in four of them persisted for up to three years. "Although this is a small study, it further highlights the potentially serious impact of HIV resistance," Pillay said.

While emphasizing the need for new drugs, Pillay pointed to prevention as vital to controlling the epidemic. "HIV is an entirely preventable disease and now more than ever we need to ensure that the prevention messages are heeded. Safer sex is the key to preventing HIV," he said.

In a related study presented to conference participants, high levels of Herpes simplex virus 2 were found among HIV patients in south London, which puts them at increased risk of transmitting HIV. The study found that among 800 HIV patients in south London, 71 percent were infected with HSV-2.

Dr. Anna Maria Geretti of the PHLS South London said: "We already know that if a patient with HIV is also infected with HSV-2, the virus which causes genital herpes, they are at increased risk of transmitting HIV to a sexual partner even if they have no herpes symptoms. Doctors may wish to consider offering HIV patients the opportunity to be tested for HSV-2 so that those infected can be made aware of the increased risk of transmission."

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