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UK HDRD finds low levels of HIV drug resistance to potential preventive drugs
UK HDRD finds low levels of HIV drug
resistance to potential preventive drugs
13 June 2012
A study by the UK HIV Drug Resistance
Database (UK HDRD), published in HIV Medicine, has found
that existing HIV drug resistance in the UK is likely to have
little impact on a new HIV prevention strategy that uses antiretroviral drugs to reduce the
risk of infection in HIV-negative people.
Recent research shows that a new HIV
prevention strategy called pre-exposure prophylaxis (PrEP) could
reduce the risk of HIV infection. This involves HIV-negative people
at risk of acquiring HIV taking existing antiretroviral drugs
before being exposed to HIV. However, research in macaque monkeys
has indicated that current drug resistance in HIV-positive people
could lead to the transmission of virus which PrEP cannot protect
against.
The UK HDRD which is coordinated by CTU,
gathers the results of most HIV drug resistance tests which are
routinely performed in the UK, and is linked to the UK Collaborative HIV Cohort (UK
CHIC) study which collects HIV-positive patient information. This
analysis examined the resistance tests from 2,678 men who have sex
with men for resistance to two HIV drugs, tenofovir and
emtricitabine.
Looking specifically at 2008, the authors
found that a man having a homosexual encounter with an
HIV-infectious partner (viral load greater than 50 copies/ml) had
between 0.9-4.1% chance of being exposed to virus which PrEP might
not have worked against.
The study also found that since 2005, levels
of potential resistance to PrEP have been declining and other
research suggests that the current levels of drug resistance in
HIV-positive people would have a limited impact on the
effectiveness of PrEP.
The authors conclude that resistance should
continue to be monitored in the HIV-positive population and future
PrEP studies.
Further information
Reference
Dolling D, Phillips AN, Delpech V, Pillay D, Cane PA, Crook
AM, Shepherd J, Fearnhill E, Hill T, Dunn D; UK HIV Drug Resistance
Database; UK Collaborative HIV Cohort (UK CHIC) Study. Evaluating
the extent of potential resistance to pre-exposure prophylaxis
within the UK HIV-1-infectious population of men who have sex with
men. HIV Med. 2012;13:309-14
