Featured Research

from universities, journals, and other organizations

World Health Organization's Plan To Monitor HIV Drug Resistance In Botswana Likely To Fail, Expert Says

Date:
January 17, 2007
Source:
University of California - Los Angeles
Summary:
A World Health Organization plan to track transmitted resistance to HIV drugs in Botswana could fail because the threshold the organization has set is too high, according to new UCLA research.

A World Health Organization (WHO) plan to track transmitted resistance to HIV drugs in Botswana could fail because the threshold the organization has set is too high, according to new UCLA research.

The authors of the study, which will be published Jan. 17 in the peer-reviewed online journal PLoS ONE (), based their research on the WHO's Botswana antiretroviral program, which began in 2002 and now treats some 42,000 patients. The program's goal is to treat 85,000 patients by 2009, roughly 30 percent of all those infected in Botswana.

As greater numbers are treated, the likelihood that a small percentage of patients will develop strains of HIV that are resistant to antiretroviral drugs increases. These patients may then transmit the drug-resistant strains to others, but the rates at which this may happen are unclear. The WHO surveillance system is intended to detect transmitted resistance exceeding a 5 percent threshold by 2009, though officials with the organization have not determined at what point this threshold might be reached, if at all.

According to the UCLA study, the WHO's detection test is based on a sophisticated statistical method, but the 5 percent detection threshold is an arbitrary one. Study co-author Sally Blower, UCLA professor of psychiatry and biobehavioral sciences and a member of the UCLA AIDS Institute, said the WHO threshold was primarily based on guesswork.

"They did not make any mathematical predictions on how long it would take to get to their threshold," Blower said. "Essentially, they've guessed what would happen. They should have done things on a more quantitative basis."

Blower and co-author Raffaele Vardavas, a postdoctoral fellow in Blower's research group, developed a mathematical model that traces the random evolution of drug-resistant strains of HIV in Botswana through 2009. They found that drug resistance would indeed emerge but likely at a much slower rate than the WHO anticipates, and the organization would not be able to detect it.

Though easy to implement, the WHO's statistical test would detect transmitted resistance only after it has reached 5 percent, and that threshold would likely not be reached by 2009 unless the drug-resistant strains of the virus are extremely transmissible, the authors said.

The authors note that while the WHO's monitoring plan requires a small sample size and is relatively inexpensive, it may not be entirely cost-effective at the early stages of the treatment program due to the high threshhold. Instead, they suggest that checking for transmitted resistance early this year and dropping the threshold to about 3 percent would present a better picture of the situation in Botswana. Although a lower threshold requires a larger sample size and is therefore more expensive, it is much more likely to detect transmitted resistance and therefore would be more useful.

"If transmitted resistance is found to be at or above 3 percent, then repeating the WHO's test in the next scheduled occasion using a 5 percent threshold value would provide more information as to how quickly transmitted resistance is increasing in Botswana," Vardavas said. "Although this would be more expensive, it would probably be more cost-effective than the current strategy."

The National Institute of Allergy and Infectious Diseases funded the study.


Story Source:

The above story is based on materials provided by University of California - Los Angeles. Note: Materials may be edited for content and length.


Cite This Page:

University of California - Los Angeles. "World Health Organization's Plan To Monitor HIV Drug Resistance In Botswana Likely To Fail, Expert Says." ScienceDaily. ScienceDaily, 17 January 2007. <www.sciencedaily.com/releases/2007/01/070116205128.htm>.
University of California - Los Angeles. (2007, January 17). World Health Organization's Plan To Monitor HIV Drug Resistance In Botswana Likely To Fail, Expert Says. ScienceDaily. Retrieved July 30, 2014 from www.sciencedaily.com/releases/2007/01/070116205128.htm
University of California - Los Angeles. "World Health Organization's Plan To Monitor HIV Drug Resistance In Botswana Likely To Fail, Expert Says." ScienceDaily. www.sciencedaily.com/releases/2007/01/070116205128.htm (accessed July 30, 2014).

Share This




More Health & Medicine News

Wednesday, July 30, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Health Insurers' Profits Slide

Health Insurers' Profits Slide

Reuters - Business Video Online (July 30, 2014) Obamacare-related costs were said to be behind the profit plunge at Wellpoint and Humana, but Wellpoint sees the new exchanges boosting its earnings for the full year. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com
Concern Grows Over Worsening Ebola Crisis

Concern Grows Over Worsening Ebola Crisis

AFP (July 30, 2014) Pan-African airline ASKY has suspended all flights to and from the capitals of Liberia and Sierra Leone amid the worsening Ebola health crisis, which has so far caused 672 deaths in Guinea, Liberia and Sierra Leone. Duration: 00:43 Video provided by AFP
Powered by NewsLook.com
At Least 20 Chikungunya Cases in New Jersey

At Least 20 Chikungunya Cases in New Jersey

AP (July 30, 2014) At least 20 New Jersey residents have tested positive for chikungunya, a mosquito-borne virus that has spread through the Caribbean. (July 30) Video provided by AP
Powered by NewsLook.com
Generics Eat Into Pfizer's Sales

Generics Eat Into Pfizer's Sales

Reuters - Business Video Online (July 29, 2014) Pfizer, the world's largest drug maker, cut full-year revenue forecasts because generics could cut into sales of its anti-arthritis drug, Celebrex. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins