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Nearly two-thirds of people in the USA who take anti-HIV therapy have failed their treatments. And half of all people on the pills are resistant to at least one drug. This was the sensational message of a paper delivered at the ICAAC Conference at Chicago in December.
Yet European studies released in the last year flatly contradict these high figures, and some say that HIV resistance may actually be decreasing.
Dr Doug Richman of San Diego's Veterans Hospital looked at 1,600 HIV patients who started treatment between 1996 and '99. 63 per cent were 'treatment failures' - that is, they had a detectable HIV viral load. Of these, 70 per cent had resistance to at least one nucleoside analogue drug (NRTIs such as 3TC, AZT, d4t etc), and nearly a third to the whole non-nucleoside (NNRTI) class.
Yet European studies tell a very different story. A recent study by Professor Amalio Telenti of Lausanne Hospital in Switzerland found that the proportion of people newly infected with drug-resistant virus actually declined threefold from 15 per cent in 1997 to five per cent in 1999.
A study from south London hospitals in September 2001 found that one in seven patients on treatment had developed resistance to at least one NRTI drug. Seven per

cent of new infections were of drug-resistant virus - a quarter of the US figures.