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(Ivanhoe Newswire) -- A new and more sensitive test for drug resistant forms of HIV may one day help determine which patients will need second-line drugs to treat the disease.
The new test was developed by investigators from the Centers for Disease Control and Prevention to improve on standard tests, which can identify drug-resistant mutations of the virus, but commonly fail to find mutations that are present in less than 20 percent of the virus in a patient's blood.
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To assess the effectiveness of the new test, the investigators first studied HIV samples from more than 500 people who had been recently diagnosed with the condition, but not yet treated with standard HIV drugs. Results were then compared with results from the standard tests. More than 10 percent of the patients had drug resistant mutations in their blood that were not picked up by the standard tests.
Then they looked at 316 additional samples taken from 1,400 people who had been started on HIV treatment with the drug efavirenz. According to the standard tests, none were positive for the drug resistant mutations before beginning the therapy. The new test, however, revealed seven out of 95 patients who ultimately failed treatment with efavirenz had mutations before starting the treatment. That compares to just two out of 211 patients for whom treatment did not fail.
So, should this test be offered to all people with HIV? Writing in an accompanying Perspective, a fellow research questions the advisability of such testing, noting many people with low levels of mutations will never experience treatment failure as a result.
SOURCE: PLoS Medicine, published online July 28, 2008
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