August 28, 2003
"The relationship between adherence and resistance is more complex than we previously understood," said David Bangsberg, a clinician with the University of California-San Francisco who published a study showing that HIV patients who were having trouble subduing the virus were more likely to develop resistance to their medications if they took most of their prescribed doses. Bangsberg's study, "HIV Levels of Adherence Do Not Prevent Accumulation of HIV Drug Resistance Mutations," is published in the Sept. 5 issue of AIDS (2003;17(13):1925-1932).
Bangsberg warned, however, that his and others' findings do not mean that patients should deliberately skip doses, because the data still show that patients who adhere better to their drug regimens live longer. Rather, researchers said, the findings indicate that patients in developing countries should be given access to the most effective drugs early in their treatment, because this maximizes their chances of controlling the virus and not developing drug resistance.
"The clear message is that in the absence of complete viral suppression, the more medication you take, the more resistance you select," said Daniel Kuritzkes, director of AIDS research at Brigham and Women's Hospital in Boston. Kuritzkes coauthored an earlier study that suggested a link between less-effective therapies and resistance.
08.21.03; Vol. 424; No. 6951: P. 866; Erika Check
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