Drug resistance Updates // Drug Repurposing

Drug resistance Updates

FIGURE 1Summary by Tim Horn
Edited by Sheldon Brown, MD and Martin Markowitz, MD


Over the past 18 months, significant amounts of data presented at scientific conferences have shed additional light on the mechanisms and clinical significance of antiretroviral drug resistance. These include new reports from studies evaluating the incidence and lingering consequences of transmitted drug-resistant HIV, the significance of the K65R mutation in reverse transcriptase, the persistence of minor HIV variants harboring drug-resistance mutations, the selection of TAM pathways, as well as some heartening data indicating that lamivudine retains some activity against HIV carrying the M184V mutation. To discuss these and other emerging data, Dr. Daniel Kuritzkes graciously accepted PRN’s offer to speak at the May 2004 meeting, the proceedings from which are reviewed here.

Drug-resistance testing has come to be recognized as an important tool in tracking the growing and troublesome prevalence of transmitted drug-resistant HIV—a problem that appears to be here to stay. To provide PRN members with an update, Dr. Kuritzkes highlighted recent epidemiological data from around the world, looking at different patterns of resistance in both newly infected and chronically infected individuals.

FIGURE 1Some of the most intriguing epidemiological data come from the CATCH study, which involved 17 European countries, evaluating the incidence of genotypic resistance in more than 1, 600 newly infected HIV-positive individuals (Wensing, 2003). The overall prevalence of HIV strains resistant to at least one antiretroviral agent was 9.6%. “What was interesting about this study was that it was able to divide patients into two groups: those who had been infected for a year or less and those who had been infected for longer than a year, based on the physician’s assessment of infection time, ” Dr. Kuritzkes said. According to the data presented at the 2nd International AIDS Society Conference on HIV Pathogenesis and Treatment, held in July 2003 in Paris, the prevalence of drug-resistant HIV among patients infected for a year or less was 10.9%, compared to a prevalence rate of 7.5% among patients infected for more than a year.

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Sickle cell

by coelentrate

Sickle cell is not the best example I gave. The best examples are lactose tolerance in humans and evolution of drug resistance in microbes because these are physical changes that humans have observed with their own eyes.
sickle cell is also circumstantial evidence. we think that the sickle cell allele should have dissapeared but it dsidn't. we guess it's malaria resistance. And we guess the reason is selective pressure.

Hard to say.

by pleni

Since bacteria don't fossilize, it is hard to determine what transitions have occurred. Here is a little bit of info on it. The interesting thing about bacteria is that one generation is very short compared to human generations. That is why we can see evolution happening in "real time" in bacteria, but can't see it in humans or other animals.
"Antibacterial resistance is an example of evolution in action. Whenever an antibiotic is used, there is always the chance that some of the bacteria will survive. Compared to the bacteria that were killed off, the survivors have genes that make them more resistant to the drug

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Awards presented at Hoyle School  — spectator.southcoasttoday
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