Resistance to antiviral drugs is climbing
http://www.100md.com
《英国医生杂志》
Public health experts have warned of a worrying increase in resistance to antiviral drugs that is making infections such as HIV and hepatitis B more difficult to manage.
HIV particles (yellow and pink) budding from the surface of a T4 lymphocyte cell (blue) in a coloured transmission electron micrograph
Credit: DR STEVE PATTERSON / SPL
Evidence from research that followed 4500 British patients infected with HIV indicates that after two years of standard treatment with a combination of three different classes of antiretroviral drugs 10% of people become resistant to at least one drug. Six years after starting treatment 27% of patients are resistant to at least one of their drugs.
Speaking at the launch of the annual report of the Health Protection Agency for England and Wales, Peter Borriello, interim director of the agency's Centre of Infections, said the most worrying development is the emergence of strains of HIV that are resistant to all three classes of antiretroviral drugs currently available. Such triple resistance now affects one in 25 people with HIV, and although some antiviral drugs may dampen down the viral load in these patients their prognosis is much worse than in someone who shows no drug resistance.
"Up to one in five people who are being diagnosed with HIV are resistant to at least one drug, which suggests they have acquired the infection from someone who is already receiving treatment," said Professor Borriello. "This tells us we have to now reinforce behaviour messages."
There is also evidence that 20% of strains of hepatitis B viruses are now resistant to standard treatment, and work with the World Health Organization indicates that resistance to drugs for influenza was emerging, although less than 1% of people were showing resistance.
William Stewart, chairman of the agency, said: "The worrying trend is that viruses that are resistant to antiviral drugs are beginning to emerge. To a micro-biologist this may be unsurprising, but it is worryingly reminiscent of the development of antibiotic resistant bacteria over 50 years ago. The fight against microbial diversity is endless."
Although the development of resistance to antiviral drugs was inevitable, cooperation from public health departments in other countries would help in monitoring the situation and in devising protocols to limit the spread of resistance, experts agree. Development of new classes of drugs by pharmaceutical companies would also provide doctors with the means to treat infections with a reduced risk of resistance developing, said Professor Borriello.(Zosia Kmietowicz)
HIV particles (yellow and pink) budding from the surface of a T4 lymphocyte cell (blue) in a coloured transmission electron micrograph
Credit: DR STEVE PATTERSON / SPL
Evidence from research that followed 4500 British patients infected with HIV indicates that after two years of standard treatment with a combination of three different classes of antiretroviral drugs 10% of people become resistant to at least one drug. Six years after starting treatment 27% of patients are resistant to at least one of their drugs.
Speaking at the launch of the annual report of the Health Protection Agency for England and Wales, Peter Borriello, interim director of the agency's Centre of Infections, said the most worrying development is the emergence of strains of HIV that are resistant to all three classes of antiretroviral drugs currently available. Such triple resistance now affects one in 25 people with HIV, and although some antiviral drugs may dampen down the viral load in these patients their prognosis is much worse than in someone who shows no drug resistance.
"Up to one in five people who are being diagnosed with HIV are resistant to at least one drug, which suggests they have acquired the infection from someone who is already receiving treatment," said Professor Borriello. "This tells us we have to now reinforce behaviour messages."
There is also evidence that 20% of strains of hepatitis B viruses are now resistant to standard treatment, and work with the World Health Organization indicates that resistance to drugs for influenza was emerging, although less than 1% of people were showing resistance.
William Stewart, chairman of the agency, said: "The worrying trend is that viruses that are resistant to antiviral drugs are beginning to emerge. To a micro-biologist this may be unsurprising, but it is worryingly reminiscent of the development of antibiotic resistant bacteria over 50 years ago. The fight against microbial diversity is endless."
Although the development of resistance to antiviral drugs was inevitable, cooperation from public health departments in other countries would help in monitoring the situation and in devising protocols to limit the spread of resistance, experts agree. Development of new classes of drugs by pharmaceutical companies would also provide doctors with the means to treat infections with a reduced risk of resistance developing, said Professor Borriello.(Zosia Kmietowicz)