Therapeutic Response of HIV‐1 Subtype C in African Patients Coinfected with eitherMycobacterium tuberculosisor Human Herpesvirus–8

Abstract

Nucleoside reverse-transcriptase inhibitor/nonnucleoside reverse-transcriptase inhibitor-based treatment regimens are highly effective in clearing rapidly replicating (phase I) virus in African patients dually infected with HIV-1 and either TB or KS.

HIV‐1 Genetic Diversity Surveillance in the United States

“…A higher prevalence of protease polymorphism and minor drug-resistant mutations are found among HIV-1 non-B subtypes [28], but there is no evidence that these influence the initial treatment response. Large, well-designed studies have so far shown an equally good response when highly active antiretroviral therapy(HAART) regimens are used, regardless of HIV-1 subtype [29][30][31][32][33]. HIV drug resistance does not seem to emerge at higher rates, and the same major resistance mutations tend to develop [34][35][36][37][38], although it appears that different pathways to resistance are taken in different proportions according to subtype [39].…”

First survey for detecting the presence of human herpesvirus 8 infection (HHV-8) in Maputo, Mozambique

“…Although the number of individuals analyzed was small, this preliminary study emphasizes the need for extending and confirming these data in order to properly prevent and treat individuals from this geographic area. Extraordinary hope for antiretroviral therapy in South Africa was observed in HIV-1 subtype C-infected patients who were co-infected with either Mycobacterium tuberculosis or HHV-8 [14,15].…”

The Extraordinary Hope of Antiretroviral Therapy in South Africa (Even for Patients with Tuberculosis or Kaposi Sarcoma!)

“…The article "Therapeutic response of HIV-1 subtype C in African patients coinfected with either Mycobacterium tuberculosis or human herpesvirus-8" in this issue of the Journal of Infectious Diseases [1] demonstrates that outstanding virologic and immunologic responses to triple combination antiretroviral therapy (ART) occur in South African patients. These observations provide important insight into the feasibility of treating HIV-infected persons in resource-limited settings.…”

“…This myth gave rise to many arguments that have been made to discourage the introduction of this extraordinary, life-saving therapy in the areas of the world that need it the most. The past 12 months have provided an array of studies, including the study by Cassol et al in this issue of the Journal [1], that have shattered this myth. The Cassol et al study [1] and studies conducted in Cameroon [4], southern India [5,6], and southern Africa [7] have demonstrated dramatically the positive impact of triple combination ART in the developing world.…”

“…The past 12 months have provided an array of studies, including the study by Cassol et al in this issue of the Journal [1], that have shattered this myth. The Cassol et al study [1] and studies conducted in Cameroon [4], southern India [5,6], and southern Africa [7] have demonstrated dramatically the positive impact of triple combination ART in the developing world. HIV-1 subtype C appears to respond no differently to ART than does subtype B. Adherence in resource-poor settings (when access is guaranteed) is excellent [8]-often better than in North American or European patients.…”