LA County Study May Double Number of Multi-Drug-Resistant HIV Cases, Aggressive Use of Antiretroviral Drugs in Asymptomatic Patients Breeds Resistance to Virus

While increasing amounts HIV treatments are hitting the market, a new study suggests that while testing early for the virus will help prevent it, aggressive use of antiretroviral drugs in asymptomatic patients could also breed more resistance to HIV. 

According to the study, one of the most widely advocated strategies for dealing with HIV/AIDS could double the number of multi-drug-resistant HIV cases in the population of men who have sex with men (MSM) in LA County over the next 10 years.

It's noted that in the U.S. alone, LA County has the largest incident population of HIV positive individuals.

The "test and treat" policy, which calls for universal testing for HIVA as well as treatment with antiretroviral drugs at very early stages of the disease, is popular because it has been shown to decrease the number of deaths due to AIDS.

Yet the study notes that such aggressive and widespread use of the antiretroviral drugs can also resistance to HIV.

"We're not saying that testing everybody and treating everybody is bad. All we're saying is that you should proceed with caution and closely monitor the prevalence of multi-drug-resistant HIV as you scale up the test and treat model," said lead author Neeraj Sood, associate professor at the USC Schaeffer Center for Health Policy and Economics.

Sood collaborated with Zachary Wagner, also of the USC Schaeffer Center; USC Ph.D. student Emmanuel Drabo; and Raffaele Vardavas and Amber Jaycocks of the RAND Corporation. Their study received advance online publication by Clinical Infectious Diseases in March.

His colleagues studied the MSM population in LA County, which accounts for 82 percent of people living with HIV/AIDS countywide. They tracked how the disease was treated from 2000 to 2009 and how the virus responded.

With data from the Centers for Disease Control and their own data, the researchers then generated a model of how the disease would respond under a more aggressive "test and treat" policy over the next 10 years.

The model showed the prevalence of MDR jumping from 4.79 percent to 9.06 percent by 2023.

Sood suggests using a more casious approach, by simply testing for the disease to avoid prescribing antiretroviral drugs to asymptomatic patients.