Nevirapine resistance is bad news. It usually
means resistance to all the current non-nucleoside class.
People resistant to 'non-nukes' have to rely on the often more toxic and
certainly more expensive protease inhibitors. That means when cheap HIV
drugs do come to South Africa there may be kids and mums dying of resistant
superbug while others live on.
It's not too late to change the prescription. Other regimes against MTCT
- including the AZT/3TC one - work just as well, and resistance develops
much more slowly.
We have been here before. Ironically, AZT was the problem then. Remember
when it was the only drug around? People were so desperate for any treatment
then that campaigners like ACT-UP did 'die-ins' in the street to get it
approved for use against Aids. So people started taking AZT - by itself.
But AZT 'monotherapy' exacted a terrible price.
A recent study (also see p.35) has found
widespread drug resistance and treatment failure in the USA. Two-thirds
failing their HIV treatment. A quarter catching drug-resistant HIV.
As often as not, that 'one drug' is AZT. The people who died while taking
AZT monotherapy left their resistant viruses behind them, like unquiet
ghosts. They haunt the positive population still, denying many a chance
of health.
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You can't just zap HIV. You have to outwit it tactically. Make the wrong move, it could checkmate you years down the line.
