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HIV May Develop Resistance Against Wonder Drug

by Karishma Abhishek on December 2, 2020 at 12:10 AM
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HIV May Develop Resistance Against Wonder Drug

Dolutegravir, the so-called 'wonder drug' is the current first-line treatment for HIV recommended by the World Health Organization (WHO) in 2019. It may be less effective than anticipated in sub-Saharan Africa, as per a research published in the journal Nature Communications, on World AIDS Day.

HIV is capable of developing errors, or 'mutations', in its genetic code (RNA) while producing its copies (replication). This allows a virus to develop resistance (less effective) against a drug that was once effective. Several drugs have lost efficacy due to resistance developed by HIV against them. One of those includes a type of drug known as non-nucleoside reverse-transcriptase inhibitor (NNRTI). As much as 10% to 15% of patients in sub-Saharan Africa are infected by a strain of HIV resistant to these drugs.

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HIV resistance and wonder drug:

The present study was conducted by an international team of researchers from South Africa, the UK, and the USA, who examined the genetic code of HIV to determine if drug resistance mutations in 874 volunteers living with HIV affected their treatment success. The individuals were enrolled in a clinical trial for people initiating HIV treatment to compare two-drug regimens: efavirenz, an NNRTI and prior first-line therapy in the region, and dolutegravir.
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Unexpectedly drug resistance was observed with patients taking Dolutegravir too. "We fully expected efavirenz to be less effective among patient's HIV strains resistant to NNRTIs. What took us completely by surprise was that dolutegravir - a different class of drug which is generally effective in the face of drug resistance - would also be less effective in people with these resistant strains. We are working now to tease out if this was due to the virus or the participants - for instance, if people with resistance are less likely to take their pills regularly. Either way, if this pattern holds true, it could have far-reaching impacts on our predictions of long-term treatment control for millions of people taking dolutegravir in the region", said Dr. Mark Siedner, a faculty member at the Africa Health Research Institute in KwaZulu-Natal, South Africa and Massachusetts General Hospital in Boston, Massachusetts.

Though the exact mechanism why efavirenz-resistant mutations should affect the susceptibility of dolutegravir was not clear, further research is being dedicated to explore the efficacy of the treatment. The study highlights the urgent need for prioritizing point of care tests to identify people with drug resistance HIVand accurately monitor treatment adherence.

Source: Medindia
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