Fewer Americans Suppressing HIV Virus, Study Finds
According to a new study, many US HIV patients are not effectively controlling their infection, mostly due to a lack of drug adherence. Young adults, African-Americans, injection drug users, and the uninsured are particularly affected.
The researchers looked at 100,000 blood tests from more than 30,000 patients over a decade - believed to be the longest review of its kind. They found 72 percent were controlling their viral loads well, which was lower than the 87 percent previously found. Still, these numbers are significantly better than 2001, when only about 45 percent had well-controlled viral loads, noted Dr. Kelly Gebo, senior study investigator and infectious-disease specialist at Johns Hopkins University.
The researchers pointed to concerns of drug resistance and putting others at risk. Dr. Baligh Yehia, a postdoctoral fellow in Pennsylvania’s School of Medicine, said, “An individual who misses one day’s worth of drugs is at risk of becoming resistant.” Also, “When you consider that over a large population, that’s how people spread the virus. ... And they may be spreading the resistant kind. It’s a dangerous spiral.”
Most people can now take one daily, multi-drug pill; however, if they become resistant to one of the drugs, they must take different medications in multiple pills, causing potential drug adherence problems. More efforts are needed to ensure drug adherence; the researchers plan additional research.
The study may increase concerns about using an antiretroviral drug for prevention among HIV-negative people, despite FDA’s recent approval for that purpose, according to Gebo. Yehia noted, “We’ve made progress, but being able to take a pill every day is a lot harder than previously thought.”
[PNU editor’s note: The study, “Sustained Viral Suppression in HIV-Infected Patients Receiving Antiretroviral Therapy,” was published in the Journal of the American Medical Association (2012;308(4):339-342).]
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