Study Reveals Low Rate of Resistance to HIV Therapy

Study by NYS and NYC Health Departments Finds That Most Newly-Diagnosed HIV Patients Do Not Have HIV Strain Resistant to Effective Antiretroviral Treatment

ALBANY, N.Y. (December 3, 2012) A first-of-its-kind statewide study of patients diagnosed with HIV found only a small percentage of these patients had a strain of the virus resistant to antiviral drugs that is used to effectively treat HIV.

In the study, "Transmitted Antiretroviral Drug Resistance in New York State, 2006-2008: Results from a New Surveillance System," two percent of newly-diagnosed HIV patients had a strain of HIV resistant to treatment with a standard antiviral drug regimen. The study, conducted by researchers from the New York State Department of Health (DOH) and the New York City Department of Health and Mental Hygiene (NYCDOHMH), analyzed laboratory data of 13,000 New Yorkers diagnosed with HIV between 2006 and 2008.

State Health Commissioner Nirav Shah, M.D., M.P.H. said, "This study demonstrates how antiretroviral medication is helping those newly infected with HIV to stay healthy and avoid transmitting the virus to others. The study findings are a testament to the high levels of quality provided in New York State HIV clinical care programs where skilled physicians follow State and federal guidelines in choosing appropriate antiretroviral agents. We promote monitoring for drug resistance before treatment is initiated to tailor regimens as needed, and continued surveillance is an important part of effective HIV treatment."

Dr. Jay Varma, Deputy Commissioner for Disease Control at the New York City Department of Health and Mental Hygiene said, "It is essential that all New Yorkers diagnosed with HIV receive medical care and have all appropriate tests performed. This important study shows that serious resistance to antiretroviral medication is rare. Nevertheless, too few persons newly diagnosed with HIV are getting HIV genotype testing, which they should receive as part of their initial evaluations."

Many patients with HIV are treated with antiretroviral therapy, which involves a combination of three pharmacological agents or medications that can specifically inhibit HIV replication. Under clinical guidelines, health care providers develop antiretroviral therapy regimens for individual HIV patients to suppress the HIV virus and stop or delay progression of the disease; restore or preserve the patients' immune function; reduce morbidity and mortality; maintain or improve individuals' quality of life; and limit the likelihood of developing resistance to the therapy.

Largely, as a result of antiretroviral therapy and other HIV/AIDS treatments, deaths among New Yorkers diagnosed with AIDS between 2002 and 2010 decreased by 41 percent. Drug resistance can develop during treatment with antiretroviral drugs, but could also be the result of a person becoming infected with a strain of the virus that is already resistant to some antiviral drugs.

In 2010, the number of New Yorkers living with diagnosed HIV was 128,653; nationwide, it was 940,600. According to this most recent study, 47 percent of newly diagnosed patients entering care within three months of diagnosis received the recommended drug resistance testing. The proportion increased from 42 percent between 2006 and 2008. In the study, 11 percent of those tested were infected with a strain of HIV that was at least partially resistant to some antiviral drugs. For two percent of these patients, resistance was high enough to interfere with a standard antiviral drug regimen.

"Continued monitoring of resistance levels is an important tool to help ensure the remarkable progress made in HIV treatment remains effective," Commissioner Shah noted.

Humberto Cruz, director of DOH's AIDS Institute, said, "It is good news that the fraction of New Yorkers diagnosed with HIV who receive initial resistance tests is increasing, but until that number is 100 percent, diagnostic centers, health departments and medical providers must to continue their efforts to ensure all people diagnosed with HIV are promptly linked to care and receive all appropriate testing."