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    HIV Drug Resistance Not Patients' Fault

    Best Patients Get Most Drug-Resistant HIV
    By
    WebMD Health News

    Aug. 20, 2003 -- You can't blame patients for HIV drug resistance.

    The AIDS virus is notoriously good at becoming resistant to anti-HIV drugs. It's common to blame patients who don't take their drugs exactly as prescribed. But that's wrong, a new study suggests.

    Study leader David R. Bangsberg, MD, is director of the University of California, San Francisco Epidemiology and Prevention Interventions Center. His team studied HIV drug resistance and adherence to anti-HIV drug regimens in 148 patients. The study appears in the Sept. 5 issue of AIDS.

    The surprising finding: Those who were best at taking their medicine were most likely to develop HIV drug resistance. There was relatively little drug-resistant virus in patients who weren't taking their medicine as prescribed.

    "There's one clear message here," Bangsberg tells WebMD. "The relationship between drug resistance and adherence to anti-HIV drugs is complex. This does not mean patients with HIV should take less of their drugs. That would be the same as taking no medications at all -- and they would go back to the natural course of HIV infection, which we know is bad."

    Medicine Takers Do Better

    Robert Gross, MD, a researcher at the University of Pennsylvania center for clinical epidemiology and biostatistics, has studied the issue of adherence to anti-HIV drugs.

    "Preventing resistance is important, but it is much more important to prevent disease," Gross tells WebMD. "Resistance is not a human outcome, it is a virus outcome. The human outcome is: Did a person get sick? And people who keep taking their anti-HIV treatment despite getting resistant virus do better than those who stop treatment."

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