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Concern over drug-resistant HIV strains

By GATONYE GATHURA

A group of women in Pumwani, Nairobi, have provided new evidence  that hard to treat HIV strains have become more widespread in the city.

Information published on Tuesday, collected from 109 HIV-infected women from Pumwani, showed up to 22 per cent of them had strains that are highly resistant to some commonly used antitretrovirals.

Such a development, says Dr Irene Mukui, the antiretrovirals manager at the National Aids and Sexually Transmitted Diseases Control Programme, could have serious health and financial implications in managing the disease.

According to her, there are 640,000 Kenyans on ARVs today, with a new push to upscale this to cover 800,000 deserving cases.

Earlier reports, including a 2005 national survey, had shown resistance against ARVs to be about five per cent, an allowable threshold by the World Health Organisation.

The study, conducted by the universities of Nairobi and Manitoba, Canada, was published on Tuesday in the journal, Retrovirology.

Most of the earlier studies on ARVs resistance, a process nationally monitored at Lumumba Health Centre in Kisumu, Kisumu East District Hospital, and Mbagathi District Hospital and the Coptic Centre, both in Nairobi, involved already infected persons who were on treatment.

However, the new study was done  on HIV-positive people who had never taken ARVs, meaning resistance did not develop during treatment but they had acquired strains that were already resistant to some common treatment options.

“The widespread circulation of hard to treat strains could complicate the management of the condition, especially if the most available drugs such as nevirapine are involved,” says Dr Nicholas Muraguri.

Resistance has been known to develop in ARV users who do not take the drugs as instructed by doctors or through natural changes in the virus.

Last October, the two institutions and the Kenya Medical Research Institute found that eight per cent of HIV-positive prostitutes on ARVs in Nairobi had developed resistance to some of the medicines.