December #30 : Resistance Gets a Wellcome - by Scott Hess and Edited by RonniLyn Pustil

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Table of Contents

Wild Kingdom

Rx Marijuana

Gender Matters

The Fabulous One

Mailbox

S.O.S.

Resistance Gets a Wellcome

Name in Vain

Go Figure

Like Butt-ah

An Aye for an Eye

To Russia Without Love

The Odd Couple

Secondhand Dose

Law and Disorder

AIDS in 2003

Catholic Cleanup

Until the Cure

Say What--December 1997

Diana, Princess of Wales

Chaka Treatment

Bear Essentials

Brace Yourself

All That Jazz

Respect Your Elders!

Bill of Health

Nunz With Attitude

POZ Picks-December 1997

Don't Mess With Mama

All Yesterday's Parties

The Light Burns Out

Peace of My Heart

Swing Your Partner

Once Upon a Lazarus

The Grim Reefer

In Case of Emergency

A DJ Saved My Life

Sweetness and Blight

"The First Cure"

Breaks for the Aches

Fishing for Supplements

When HIV Drugs Fail

Mary Fisher Gets Mad

Music Is Medicine



Most Popular Lessons

The HIV Life Cycle

Shingles

Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV


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December 1997

Resistance Gets a Wellcome

by Scott Hess and Edited by RonniLyn Pustil

New test may revolutionize drug decisions

The protease revolution has dealt some dizzying treatment decisions. In this gambler's paradise, resistance is the wild card: Sooner or later, the virus shuffles its genes and trumps each drug. Viral load and CD4 counts can give a guesstimate about when a treatment starts and stops working, but measuring the specific mutations may better your odds by alerting you to which drugs your virus can resist-each of the 12 available anti-HIV drugs has its own mutation pattern, but unfortunately, cross-resistance is increasingly common. Now researchers at Wellcome Diagnostic have devised a test that does exactly that for the reverse-transcriptase gene. Called the LIPA HIV-RT, the gadget is said to be 99 percent accurate in detecting changes in the site that AZT, ddI and the other nukes target. "Unless you have a genetic research laboratory at your doorstep, the new test is the most effective way to get a genotypic assay," said Dr. Brian Gazzard of Chelsea and Westminster Hospital in London, adding that the technology is soon likely to be adapted to assess resistance to protease inhibitors. The new test is about to go on the market in Britain. The Treatment Action Group's Spencer Cox predicted that "within a year or two, the RT test will be standard procedure."

But making treatment decisions based on tests measuring resistance is a risky practice. Doctors who use Specialty Labs' genetic-testing service, the first on the market, report that a list of genotypic mutations is, at best, only one piece of the puzzle. These lab tests can't measure whether-or what proportion of-the virus in your body is actually resistant to a drug, so their results must be interpreted with great care, in the context of viral load, CD4 counts and other factors.



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