Researchers develop questions to determine risk of HIV/AIDS drug resistance

Researchers from the Makerere University hospital in Uganda, the U.S. and Belgium have developed a formula, based on a set of questions, for determining HIV-positive people's risk of treatment failure and drug resistance, according to a study recently published in the Journal of the International AIDS Society, the New York Times reports.

According to the Times, most HIV-positive people in Africa rarely have access to viral load tests to determine if they are developing resistance to first-line antiretroviral drugs because the testing is expensive and complicated.

The researchers questioned 496 HIV-positive people about:

• How often they had taken their drugs in the past three days, the previous four weeks and since they began treatment;
  
  
• If they had ever missed two days of drugs;
  
  
• If they had ever paid for treatment;
  
  
• Whether women had ever taken nevirapine to prevent mother-to-child transmission; and
  
  
• If the patients had experienced weight loss or rashes.
  

The researchers also took blood samples to determine the participants' CD4+ T cell counts. They found that having ever missed treatment for two days or a 30% decrease in CD4+ count predicted treatment failure. The researchers said that viral load testing, when available, be given to these patients first. In addition, the Times reports that the new method appears to work better than World Health Organization guidelines, which are based on clinical signs of HIV progression and CD4+ counts (McNeil, New York Times, 5/18).

The study is available online.