HIV drug resistance high in France

NEW YORK (Reuters Health) - About 82% of HIV isolates in France are resistant to one or more antiretroviral agents, according to a report published in the November 7th issue of AIDS. Of particular concern, 26% of patients carry a virus that is resistant to agents from all three main drug classes.

The new findings are similar to those from a recent US study that reported drug-resistant HIV in nearly 80% of infected adults. Moreover, in a UK study released last month, 79% of patients were infected with a strain resistant to at least one agent (see Reuters Health stories December 18, 2001 and October 24, 2003).

In the current study, Dr. Catherine Tamalet, from CHRU La Timone in Marseille, France, and colleagues assessed HIV drug resistance by analyzing data on over 7000 HIV genotypes that were submitted for testing between 1997 and 2002.

The prevalence of resistance varied according to drug class: 78.3% for nucleoside reverse transcriptase inhibitors (NRTI), 47.0% for protease inhibitors, and 38.9% for non-NRTI. The most common pattern of multidrug resistance was resistance to a NRTI and a protease inhibitor, seen in 45.5% of isolates.

Although the prevalence of triple class resistance jumped dramatically from 3.4% in 1997 to 24.0% in 1999, it appears to have stabilized in the last 2 years at around 26%.

"The high prevalence of resistance mutations emphasizes the increasing risk of the transmission of drug-resistant viruses among the population as well as the urgent need for the development of new therapies based on different retroviral targets," the investigators conclude.

AIDS 2003;17:2383-2388.