Researchers warn of serious repercussions if efforts taken to bring down infections are not consistent, say they want to study why therapy does not work on some people with virus

Concerned over the number of HIV-infected patients who have received anti-retroviral therapy (ART) but not responded to the treatment, the National Aids Research Institute (NARI) has decided to set up a database of such Indian patients. Scientists at NARI said the reason behind the failure was drug resistance, which poses a big challenge for researchers as well as treatment protocols for HIV.

Fighting on: NARI director Dr R S Paranjape says fresh HIV infections
are on the decline but scientists can not afford to rest and must find out
why ART does not work for some people. Pic/Krunal Gosavi

In a bid to bridge this gap between treatment and drug resistance, NARI plans to gather data on Indian HIV-subtype C virus. "Treatment gets limited due to side effects and drug resistance and we want to study this resistance. Our virus bank currently has been studying the genetic make up of the virus as well the genomic changes that take place. Now we intend taking samples of patients from ART centres and studying the pattern of drug resistance," said Dr R S Paranjape, director, NARI.

In 2009, it was estimated that 2.4 million people were living with HIV and nearly four lakh were on ART.
While it is a known fact that early ART has increased survival rates, a proportion of patients receiving ART have also succumbed to the virus as the treatment did not work, which is disturbing researchers.

"Our virus bank already has strains from across India with different subtypes and recombinants which help scientists to test anti-virals and vaccines and conduct basic laboratory research as well. We are taking this step to find out what actually happens during drug resistance and what we can do to overcome that," said Paranjape.

The database will be especially important as currently no such data is available on Indian patients and the virus and subtypes prevalent in India. According to scientists, most of the data currently available on the virus and drug resistance is from western countries and it may not even be applicable in the Indian context. Paranjape also cautioned that even though the number of fresh infections was dwindling, efforts to prevent the HIV-AIDS epidemic should not be slowed down as it would have serious repercussions. "It's not enough to be happy looking at the figures and areas in which therapy has worked. More important is looking at the areas where either prevention or therapy didn't work," said Paranjape.