Study author Mark Jacobson, MD, suggested that retinitis might develop as a result of an inflammatory response that comes into play as CD4 cell numbers increase. Resistance Testing Available Specialty Laboratories in Santa Monica, CA, announced in May the development of a test to measure HIV resistance to antiretroviral drugs. The HIV-1 GenotypR PLUS blood test is available to physicians who want to pinpoint HIV mutations present in their HIV positive patients. The DNA sequencing test can measure resistance to AZT, ddI, ddC, d4T, 3TC and the 4 approved protease inhibitor drugs. Genotypic testing looks for changes in the genetic structure of HIV that are associated with resistance to antiretroviral drugs.
Some drugs remain clinically useful despite the development of characteristic resistance mutations.
Ritonavir is available in a liquid formulation for children, and nelfinavir is available in a vanilla-flavored powder. The regimen was well tolerated and no serious adverse side effects were reported. Suppression of HIV replication was sustained over 6 months of treatment. The researchers concluded that combination antiretroviral therapy is most effective when started early in HIV infection. Another article in the May 8 New England Journal of Medicine reported on a study of the pathogenesis of HIV infection in perinatally infected infants.