Genetic Basis


Healthcare Considerations

Public Policy Considerations



Facts & Figures

Prevalence statistics in HIV must be viewed differently since the life cycle of HIV produces many mutations.. This process leads to the development of some resistant strains in all individuals prior to initiation of therapy. While there are resistant strains within the lymphoid tissue of all HIV-infected patients, response to initial therapy is determined by the strain of virus the patient has been infected by.

The success of highly active antiretroviral therapy (HAART) has increased the number of people who are living with HIV, but has also increased the number of people who develop strains that are multidrug-resistant . This has led to an increased number of treatment-naive patients who have been infected with viral strains already resistant to one or more standard antiretroviral therapies.

The prevalence of mutations already present in treatment-naive patients varies among demographic regions. In a large European study conducted from 1996 to 2002, the prevalence of primary resistance was about 10%. (Wensing 2003). A study of 371 isolates of treatment-naive patients in 40 United States cities showed a resistance mutation rate of 14%. (Ross 2004). In San Francisco, the prevalence of resistance among patients with acute or recent infections was 26%. (Grant 2003)

The prevalence of resistance is important when making decisions regarding initiation of HAART. The rising rate of resistance has led to expanded recommendations for the use of resistance testing to guide antiretroviral therapy.

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