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Without doubt, antiretroviral (ARV) drugs are seen as one of the key ways to both treat and prevent HIV infection. And despite financial and practical barriers, many developing countries are now able to provide ARVs to their populations.

However, with drug resistance on the increase, there are concerns that resistant strains could make it extremely difficult to prevent mothers from passing the disease on to their children. Such resistance would render drugs such as nevirapine useless, which would be “disastrous”, according to a group of Dutch and Canadian researchers in this letter to Science.

They propose that certain ARVs should be exclusively reserved for preventing mother-to-child transmission. They argue that if drug resistance becomes widespread, treatment will actually hinder prevention, and ask whether this should be accepted as an “inevitable consequence” of the benefits that ARVs give to millions of adult HIV patients.

Link to letter in Science

Reference: Science 298, 2129 (2002)