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HIV Drug Resistance Not Patients' Fault

Best Patients Get Most Drug-Resistant HIV
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Bad Patients Still Worth Treating

It's sometimes argued that anti-HIV drugs shouldn't be offered to patients who won't take them as prescribed. That's a bunch of hooey, Bangsberg and Gross argue.

Both have published studies showing that doctors simply can't predict which patients will fail to follow doctors' orders. Now, they note, there's no compelling public health reason not to offer the drugs to anyone who wants them.

That's true, says Scott Holmberg, MD, senior epidemiologist at the CDC's National Center for HIV, STD, and TB Prevention.

"One often hears the reason you shouldn't give anti-HIV drugs to some groups of patients is that those who are only partially compliant are more likely to develop resistance," Holmberg tells WebMD. "This study may make people more reassured to start therapy with people who they think will not be adherent."

Gross says researchers should work on ways to improve adherence.

"The goal is to get patients to adhere to treatment as well as they possibly can," Gross says. "Yes, the best patients get more resistance. But they are not going to get as sick as those who adhere poorly and progress to AIDS. Let's work on getting people to adhere. If they develop resistance, so be it."

And while nobody wants to see HIV drug resistance develop, there's a silver lining. Many drug-resistant HIV strains are less deadly than other types of HIV, Gross notes.

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