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Test and Treat Program May Contribute to Drug Resistant HIV (LA Study)...

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Ann:
I also have to wonder if they're putting people on meds before they've had resistance testing done and had the result back. It sounds like they're putting people on meds the minute they've tested positive.

If what they're saying is true about so many of these people becoming multidrug resistant, then it may be that they were infected with a resistant strain to one drug, and when given that drug in a combo, they then more easily become resistant to the other two meds in the combo because one isn't working.

I suspect the first theory I came up with is probably the more prevalent reason though.

I wish news agencies would write an intelligent hiv-related article for once, instead of these "dumbed-down", generalised pieces of ... crap. Sorry, can't think of a better word for it at midnight. I should be in bed.

mecch:
exactly. dumbed down doo doo.

aaware72:

--- Quote from: Ann on March 20, 2013, 08:01:51 PM ---I also have to wonder if they're putting people on meds before they've had resistance testing done and had the result back. It sounds like they're putting people on meds the minute they've tested positive.

If what they're saying is true about so many of these people becoming multidrug resistant, then it may be that they were infected with a resistant strain to one drug, and when given that drug in a combo, they then more easily become resistant to the other two meds in the combo because one isn't working.

I suspect the first theory I came up with is probably the more prevalent reason though.

I wish news agencies would write an intelligent hiv-related article for once, instead of these "dumbed-down", generalised pieces of ... crap. Sorry, can't think of a better word for it at midnight. I should be in bed.

--- End quote ---

Hi Ann,

I was started on Complera before my resistance test results were back.  My first CD4 count was 230 and it was recommended by my doctor to start medication right away and not wait for those results. 

My partner who also tested positive had CD4 count of 660.  It was recommended for him to start medication right a way also, however they wanted to wait on the resistance test to avoid this issue. 

The author of the article may be pulling this information from here:

Abstract

Background:

There is evidence to suggest that antiretroviral therapy (ART) and HIV testing reduce the probability of transmission of HIV. This has led health officials across the US to take steps towards a test-and-treat policy. However, the extent of the benefits generated by test-and-treat is debatable, and there are concerns, such as increased multi-drug resistance (MDR), that remain unaddressed.

Methods:

We developed a deterministic epidemiological model to simulate the HIV/AIDS epidemic for men who have sex with men (MSM) in Los Angeles County (LAC). We calibrated the model to match the HIV surveillance data from LAC across a ten-year period, starting in 2000. We then modified our model to simulate the test-and-treat policy and compared epidemiological outcomes under the test-and-treat scenario to the status quo scenario over the years 2012-2023. Outcome measures included new infections, deaths, new AIDS cases, and MDR.

Results: 

Relative to the status quo, the test-and-treat model resulted in a 34% reduction in new infections, 19% reduction in deaths, and 39% reduction in new AIDS cases by 2023. However, these results are counterbalanced by a near doubling of the prevalence of MDR (9.06% compared to 4.79%) in 2023. We also found that the effects of increasing testing and treatment were not complimentary.

Conclusions: 

Although test-and-treat generates substantial benefits it will not eliminate the epidemic for MSMs in LAC. Moreover, these benefits are counterbalanced by large increases in MDR."

http://cid.oxfordjournals.org/content/early/2013/03/05/cid.cit158.short




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