AIDS: Drug Resistance Growing in Parts of Africa, a Study Says - New York Times

Mariella Furrer for The New York Times

Mpumelele, 18-months-old, receives antiretroviral treatment from his cousin, as his grandmother holds his hand.

In a worrying sign for the course of the AIDS epidemic, resistance to antiretroviral drugs is increasing in parts of Africa, according to a new study by the World Health Organization and University College London.

The report, published online Monday by The Lancet, summarized data from more than 200 smaller studies performed in Africa, Asia, Latin America and the Caribbean. Drug resistance was serious only in eastern and southern Africa, and mostly involved a class of medications called non-nucleoside reverse transcriptase inhibitors. (The most common are nevirapine and efavirenz, sold as Viramune and Sustiva.)

Eight years after affordable generic AIDS drugs were introduced in east Africa, 7.4 percent of viral strains tested were drug-resistant; in southern Africa, the hardest-hit part of the world, the figure was 3 percent.

The authors said resistance was “not unexpected,” since nearly eight million poor people have received the drugs in the past decade. But it is still worrisome; while generic manufacturers make some modern AIDS drugs with fewer side effects, only a few classes are made in generic form. Drug companies fight hard to keep exclusive control over their newest inventions so prices and profits remain high.

The authors of the new report suggested strengthening pharmacy supply chains to prevent shortages â€" a chronic problem in poor countries. They also called for better tracking of patients for whom drugs are prescribed. Anyone who stops therapy, even briefly, is much more likely to develop a drug-resistant strain.