In South Africa, drug-resistant HIV emerging

http://www.msnbc.msn.com/id/34624393/ns/health-aids/

By MARGIE MASON AND MARTHA MENDOZA
updated 9:40 a.m. ET, Wed., Dec . 30, 2009

PRETORIA, South Africa - EDITOR'S NOTE: Once-curable diseases such as tuberculosis and malaria are coming back, as germs rapidly mutate to form aggressive strains that resist drugs. The reason: The misuse of the very drugs that were supposed to save us has built up drug resistance worldwide. Fourth in a five-part series.

It's 8 a.m. and Dr. Theresa Rossouw is already drowning behind a cluttered desk of handwritten HIV charts — new, perplexing cases of patients whose lifesaving drugs have turned against them.

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Rossouw is on the front lines of a new battle in the fight against HIV: The drugs that once worked so well are starting not to work. And now the resistance is showing up in sub-Saharan Africa, home to two-thirds of the world's 33 million HIV cases.

Ten years ago, between 1 percent and 5 percent of HIV patients worldwide had drug-resistant strains. Now, between 5 percent and 30 percent of new patients are already resistant to the drugs. In Europe, it's 10 percent; in the U.S., 15 percent.

In sub-Saharan Africa, where the drugs only started arriving a few years ago, resistance is partly the unforeseen consequence of good intentions. There are not enough drugs to go around, so clinics run out and patients can't do full courses. The inferior meds available in Africa poison other patients. Misprescriptions are common and monitoring is scarce.

The story of HIV mirrors the rise worldwide of new and more deadly forms of killer infections, such as tuberculosis and malaria. These diseases have mutated in response to the misuse of the very drugs that were supposed to save us, The Associated Press found in a six-month look at soaring drug resistance worldwide.

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In sub-Saharan Africa, resistance rates have quietly climbed to around 5 percent in the past few years, and that's a substantial undercount. It's hard to pinpoint resistance because most cases in the developing world aren't tracked. In some high-risk populations worldwide, HIV drug resistance rates soar as high as 80 percent, according to studies published in AIDS, the official journal of the International AIDS Society.

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