Thursday, 13 December 2012

Foreigners blamed for spreading drug resistance to HIV in China

Resistance to protease inhibitors is being transmitted by contact with foreigners to gay men in China
by Michael Woodhead
Resistance to anti-HIV drugs such as protease inhibitors is on the increase in China and foreigners are to blame for introducing the drug resistance gene mutations into the country via gay sex, Beijing researchers say.
A national study of drug resistance genes in 489 gay men from 19 provinces found that one in twenty of them already had  acquired resistance to some anti-HIV drugs depute never having had any drug treatment.  The most common form of drug resistance  seen was to protease inhibitors, although these are rarey used as first-line treatment in China, according to Dr Yang Juan and colleagues at the National Centre for AIDS Control and Prevention in Beijing.
In their study they note that the types of HIV virus seen in China vary from region to region. In Beijing the most common strain of HIV is a unique one not seen elsewhere in China, and which is known as subtype B, which is known to  entered China through visitors from Western countries,
"This suggests that an early driver of infections [in men who have sex with men] in this area may have been through sexual contacts with Westerners," they researchers say.
The finding that more than 70% of drug resistance seen in China was to  the seldom used protease inhibitors also suggests that drug resistance is being transmitted to Chinese people from foreigners, they add.
"Sexual networks of [gay men] extending across international borders facilitates transmission of HIV and primary drug resistance. In China, [gay men] are concentrated in major cities, where they have more chances to have close social and sexual contacts with partners from foreign countries with more diverse and prolonged ART experience. This suggests that the high rate of drug resistance to protease inhibitors among Chinese gay men may be derived from frequent international travel and sex with foreign-born partners."
They also warn that the spread of HIV and drug resistance will not be confined to gay men but will spread to the heterosexual population because many gay Chinese men are married.
"Due to cultural and social pressures, many [gay men] are married to women and/or are engaged bisexual relationships and thus serve as a bridge population in bringing HIV infection and other sexually transmitted diseases to their female partners," they say.
"Our findings confirm the urgent need for transmitted drug resistance surveillance in order to optimise treatment effects of the National antiretroviral therapy Program," they conclude.
Source: Archives of Virology

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