Category: Antimicrobial resistance

Cat Links Antimicrobial resistance, Antiviral resistance

HIV infection and HIV drug resistance

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HIV infects and destroys cells that fight germs in our bodies. The medicines used to prevent the multiplication of HIV in our bodies are called antiretrovirals. There are different types of antiretrovirals, each of them targeting a different part of the virus. To prevent the multiplication of HIV, in a substantial way, a combination of antiretrovirals is used at the same time (combination therapy). The goal of combination therapy is to reduce the amount of virus in our bodies to a very low level and quickly too, so that those cells in our bodies that fight disease are no longer killed by HIV; and are produced in good number and quality to do their work. Also, when the amount of virus in our bodies is small, the chance of transmitting the virus to others is also low. As a result, treatment for HIV is now considered as an important tool for prevention. One major challenge to the outcome of antiretroviral therapy is the emergence of HIV that is resistant to treatment, that is drug resistance. When HIV is no longer destroyed by a combination of antiretrovirals, then the virus is not controlled in our bodies. This also means the treatment has failed. Therefore, another combination needs to be decided upon, after finding out why the initial combination failed. Alternative combination therapies are, many times, not easily accessible, have more side effects, and are more expensive. HIV develops resistance by making changes to sections of its gene that lead to ineffectiveness of a drug that had an effect on those sections. Our roles to prevent the development of HIV drug resistance Research has shown that poor adherence to treatment is one of the major contributors to the development of HIV drug resistance. Other contributors include how our bodies breakdown the medicines, availability, and accessibility. Poor adherence is when an individual does not take medicines as prescribed, and this can be due to psycho-social factors. These include the mental state of the individual and how society relates to those who are HIV infected. Individuals and communities can help people on HIV treatment to reduce the chance of drug resistance development. We know that HIV treatment is long-term, so we can support our friends and relatives by encouraging them to stay on treatment and remind them to get refills, we should not discriminate against those with HIV at home and at the workplace, we should be sensitive to the challenges they may have such as decisions for family, education, and getting employed and staying on the job, or starting their own business. In short, we should be buddies to those on HIV treatment so that we can provide the social and environmental support they need to prevent the development of drug resistance, get cheaper treatment, not endure more severe side effects from alternative drugs, and live near-normal lives. Resistance to HIV treatment is of global concern and it is an aspect of Antimicrobial resistance. You can read more about the relationship between adherence, HIV drug resistance, and viral suppression here https://pubmed.ncbi.nlm.nih.gov/33407664/

Cat Links Antimicrobial resistance

Antimicrobial resistance

Posted on pascalbessong

Antimicrobial resistance is when a germ thrives in the presence of a medicine that previously inactivates or kills it. Generally, medicines that kill germs are called antimicrobials. Antimicrobials have played and continue to play a great role in the promotion of global health, socio-economic development, and advancement of nations and civilization. The discovery of penicillin is a case in point. So, it is of huge concern when antimicrobials begin to lose their efficacy as a result drug resistance development. There are several reasons why germs do develop resistance to medicines. One reason could be that a strain of the microbe that was naturally resistant multiplies and becomes the majority strain. A second reason is when, over time, a microbe develops ways to avoid the medicine. Antimicrobial resistance is a big problem all over the world. This is because it makes cheap available medicines useless. As a result there is much suffering from infectious diseases and deaths. However, individuals have a vital role to play in the control of antimicrobial resistance. This can be done by taking only the medicines prescribed by an authorized health care personnel, for the duration prescribed, and by purchasing medicines only from authorized vendors. It can be difficult for some people to practice these, for example, when one cannot access a health care facility for prescriptions or when counterfeit medicines find their way into legitimate supply chain processes. Communities of low socio-economic status suffer the most from antimicrobial resistance. This is mainly because individuals from these communities cannot afford the expensive alternative antimicrobials. This can make people die from a germ causing illness because the medicines they are given do not kill the germ and there are no affordable options. This can happen for viral, bacterial, fungal or parasitic infections. As we noted in another post HIV infection and HIV drug resistance, resistance to HIV drugs is a threat to the treatment and elimination of HIV infections. The objective of global health research and education is to improve access and equity to healthcare. However, it is very important for the perspective and voice of communities, particularly communities of low socio-economic status to be heard. This is because the strategies or interventions developed to support communities would have a higher chance of success and sustainability in a partnership between science and communities. Antimicrobial resistance is a global problem. In 2015, the World Health Assembly described efforts to reduce antimicrobial resistance as a global priority. It threatens the usefulness of available medicines, and the health and socio-economic development of communities. It takes years and a lot of resources for a new antimicrobial to be developed, so it is very important that available antimicrobials remain effect and accessible to all. A study which I lead, showed that even in young children, who are not sick and have never received antibiotics, you can find gut bacteria that have genes coding for a variety of antibiotic resistance http://www.samj.org.za/index.php/samj/article/view/11819/0. It is very important to find out how these young children acquired antibiotic resistant bacteria so early in their life. The answers may lead to the design of appropriate measures to prevent its occurrence. Dr Richard Guerrant, University of Virginia, USA https://globalhealth.virginia.edu/Guerrant, and myself have advocated, through a guest editorial for the South African Medical Journal, for surveillance of antibiotic resistance to be carried out at the population http://www.samj.org.za/index.php/samj/article/view/11827. If we do this, we can better understand the burden and dynamics of the problem. Sustained efforts from different angles are needed to curb the rise of antimicrobial resistance. This is because there are different causes of the development of antimicrobial resistance: the unnecessary prescription or under prescription of antimicrobials, the use of antibiotics in livestock, self-medication, and the use of counterfeit substandard medicines. It will be interesting to know your views about antimicrobial resistance, and what you think individuals and the lay leadership in communities, such as non-governmental organization, can do to control and prevent antimicrobial resistance development and spread in communities.