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...Whatever happens, the new study suggests that HIV therapy is only going to become trickier and more expensive to implement as drug resistance spreads. While the implications for this trend will be felt most acutely in sub-Saharan Africa and parts of Asia, Kahn says he also has concerns for his home city of San Francisco. "California is broke, and the state is invading city finances to help itself out. I look at our model and what it predicts for San Francisco over the next few years in terms of antiretroviral resistance, and I do become concerned that funding...
...study in the journal Science suggests that such thinking is too good to be true. And the problem is drug resistance. Extensive antiretroviral treatment can result in the development and transmission of drug-resistant strains of HIV - something the Lancet study did not consider. In the new study, published on Thursday, a team of scientists from the University of California, the University of Tennessee and the University of Ottawa analyzed data from San Francisco, where antiretroviral drugs have been extensively prescribed to HIV patients since AZT was introduced in 1987. In that city, drug resistance has grown steadily and, according...
...According to our models, drug resistance in San Francisco will increase by around 30% in the next three to five years," says Sally Blower, a professor at the David Geffen School of Medicine at UCLA. "That will present its own challenges to that city, but the most significant implications of our work are for countries where treatment is just being rolled out. San Francisco is always the canary in the mine...
...Kahn, a professor of medicine at the University of California, San Francisco, and a contributor to the Science study, says test and treat should not be confused with WHO's goal of universal access to antiretroviral drugs, which he says is a worthy one. But because the treatment for drug-resistant HIV strains is expensive - it requires a constantly changing cocktail of new, pricey drugs - and because adherence to such a complicated drug regimen can be difficult for patients, Kahn believes WHO and other institutions should begin planning for the time that HIV drug resistance begins in earnest, particularly...
...Alvaro Bermejo, executive director of the International HIV/AIDS Alliance, says the new study underlines the increasingly urgent need for the development of an effective HIV vaccine, which has so far eluded researchers. He also says that because the study provides evidence showing that drug resistance will continue to rise in developing countries, it will likely increase pressure on pharmaceutical companies to join "patent pools" for their more expensive second- and third-generation antiretroviral drugs. In such an arrangement, an umbrella organization like UNITAID manages a pool of patents that allows generic producers to make second- and third-generation drugs...