African patients with non-B subtypes respond to HAART
Polly Clayden, HIV i-Base
There are concerns about the susceptibility of African non-B HIV-1 subtypes (largely A, C and D) to current antiretroviral drugs, which were designed, tested and validated against the European and North American HIV-1 subtype strain.
A study published in AIDS (August 17th) by Dr Frater and colleagues from St Mary’s Hospital in London assessed 79 African patients with non-clade B virus prescribed combination antiretrovirals, from their database to evaluate diverse viral subtypes and their impact on outcome of treatment with HAART.
The authors found that patients infected with non-B strains of HIV-1 responded very well to HAART (whether PI or NNRTI based) and there is no virological reason for therapy not to succeed in this group. There were no differences of outcome associated with country of origin, the subtype or the therapy group. The authors concluded that ‘Virologically, there are excellent reasons why African patients should benefit from the significant advantages conferred by HAART.’ They also emphasised that these findings have implications for those advocating therapeutic protocols in sub-Saharan countries, as well as the management of HIV-positive patients in the industrialised world.
Frater AJ et al. Impact of baseline polymorphisms in RT and protease on outcome of highly active antiretroviral therapy in HIV-1-infected African patients. AIDS 2001;15:1493-1502.