HIV: low drug resistance in Mumbai
R. PRASAD
Two years after starting the antiretroviral therapy (ART) for HIV infected people with a CD4 count less than 200, efforts are under way to understand drug resistance.
A threshold survey to understand drug resistance in people who have been recently infected was done last year in Mumbai and Kakinada, Andhra Pradesh.
A threshold survey is a preliminary study undertaken to check for drug resistance. It is done to see if a full-fledged large-scale study for drug resistance needs to be undertaken. The threshold survey undertaken in Mumbai included 47 HIV-infected individuals. “Only one person showed drug resistant mutation,” said Dr. R. Paranjape, Director of the National AIDS Research Institute (NARI), Pune. “This indicates very low drug resistance.”
In the case of Kakinada, 57 samples have been collected. Only ten have been tested, and none of the ten samples has shown any drug resistant mutation.
The very low prevalence of drug resistance in Mumbai indicates that drug resistant virus is not circulating in the general population.
But Dr. Paranjape is cautious about drawing any conclusions based on the Mumbai results alone. “The result is from just one city,” he said. “And the possibility of some people who have not been recently infected being a part of the survey cannot be ruled out.”
Another study
Another study to study the prevalence of drug resistance in people who are on ART was started last year in Chennai and Mumbai. Hundred and fifty patients from each city were enrolled.
The plasma viral load to know the level of HIV in blood was done at the start of the one-year study.
Patients on ART should show reduced viral load. “Plasma viral load test will be done in those patients in whom the viral load has gone up,” Dr. Paranjape said.
Most of the patients in both the cities have completed one year after the initial viral load test. “Hopefully we will have the data in another 2-3 months,” he said.
The initiative to study drug resistance has been jointly undertaken by World Health Organisation (WHO), National AIDS Control Organisation (NACO), Delhi and NARI, Pune.
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