A new test allows to improve the efficacy of HIV therapy in most difficult to treat patients | Fight AIDS Foundation

A new test allows to improve the efficacy of HIV therapy in most difficult to treat patients

04/07/2014

After decades of research, antiretroviral therapy has shown great success and the different drugs available today have contributed to increase both life expectancy and quality of life in those affected. 

However, there is a group of people living with HIV in which therapies are not working, the so called hard-to-treat patients: their viruses have become resistant to many HIV drugs. Some of them had to start treatment when the combinations of drugs were not as effective as current ones, whereas others have had poor adherence to medication (difficulties to follow the treatment properly). In these situations, HIV replication becomes very hard to block and their viruses keep replicating significantly leading to further accumulation of resistances.
 
To choose the right treatment for these patients, the most difficult ones to treat, physicians analyze the degree of resistance of HIV to the different drugs available. With this information, they select the combination of drugs which is more likely to block HIV. However, current tests underestimate the true burden of HIV resistance, missing relevant information.
 

In a study published in the journal Clinical Infectious Diseasesresearchers from the Institute for AIDS Research IrsiCaixa, in collaboration with the Fight AIDS Foundation and other centers, hace demonstrated the efficacy of a new test that allows to improve the response to treatment of the so called hard-to-treat patients. The test uses new ultra-sensitive sequencing platforms to detect with high precision that HIVs that have become resistant to treatments. It detects more resistance than with previous tests in 25% of patients.

This new test will allow doctors to predict which drugs are effective with higher accuracy than with current methods. Roger Paredes, HIV physician and researcher at IrsiCaixa and the Fight AIDS Foundation, and senior author of this paper, remarks that “improving drug resistance assessments will ensure that patients receive the most effective treatments and will avoid abolishing future treatment options for them”.

The findings of this study are already being translated into clinical practice: IrsiCaixa and the Fight AIDS Foundation will implement ultrasensitive tests to detect HIV resistance into clinical diagnostic routine before the end of 2014. “Given the fact that we have proved how important ultrasensitive testing is, we are ready to apply this system to all our patients in regular follow-up”, explains Roger Paredes. "It will not only be more effective and efficient in the long-term, but it will also be cheaper, as it can process more samples in less time”, says Dr. Bonaventura Clotet, head of the HIV Unit at the Germans Trias Hospital and the Foundation's chairman. Dr. Clotet states: “We are very proud to see that a finding lead by our team will have an immediate application in the daily management of people living with HIV”.

This project was carried out in collaboration with researchers and physicians from: the Instituto de Investigación Biomédica Hospital 12 de Octubre from Madrid, Hospital San Cecilio from Granada, Hospital MútuaTerrassa, Germans Trias i Pujol Hospital, in Badalona, the software company from Luxembourg Advanced Biological Laboratories (ABL, SA) and Roche Diagnostics, Spain. The study was supported through a grant from the Centro de Desarrollo Tecnológico e Industrial (CDTI) from the Spanish Ministerio de Economía y Competitividad. 

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