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[BEIJING] HIV drug resistance is emerging as a major threat to China's fight against HIV/AIDS, say researchers.

The results of a study in central China were revealed at a news conference last week (22 November).

Chen Zhiwei, director of the AIDS Institute at the University of Hong Kong, was quoted by Reuters saying that a significant number of AIDS patients receiving free antiretroviral treatment had developed resistance to the drugs and their disease had progressed to full-blown AIDS.

Antiretroviral treatment — which cannot eliminate HIV in patients but can curb the virus's replication — is the only way to prevent the progression of HIV/AIDS.

In an interview with SciDev.Net, Chen confirmed that he had studied more than 300 patients in the past two years, and HIV drug resistance among them had become a serious problem.

He refused to give an exact proportion of patients who had developed drug resistance, saying the statistics are still being checked and evaluated. But he did reveal that the study had identified the specific drug resistant strains being transmitted.

A separate study by the Beijing-based Chinese Center for Disease Control and Prevention, published in the July issue of the Chinese Journal of Public Health, revealed drug resistance in HIV/AIDS patients in the Henan province, central China. Of patients receiving two-year antiretroviral treatment, 48.2 per cent showed signs of drug resistance against a common combination of drugs Zidovudine, Didanosine and Nevirapine.

"The high level of drug resistance needs effective interventions," write the researchers.

China began to offer free antiretroviral treatment to AIDS patients in 2003. By the end of 2005, more than 20,000 patients had received the treatment.

Chen says drug quality, patients missing doses, and improper use of antiretroviral drugs — using drugs too early in the course of the disease, for example — can all lead to drug resistance.

"Many patients in the countryside cannot continue taking doses once there are side-effects. This has contributed to growing resistance," Chen says.

He adds that it is urgent for China to offer free or cheap second-line drugs to patients, that combat viral strains resistant to conventional first-line drugs.

China cannot produce most second-line drugs due to patent restrictions.

Zhang Linqi, executive director of Tsinghua University's AIDS Research Centre, which was launched this week (27 November), says that when the second-line drugs are unavailable, it is crucial to maximise the effect of current therapies.

"We need to educate patients and grassroots medical workers to properly use the available drugs," Zhang told SciDev.Net.

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