A small but growing proportion of HIV infected patients in the United Kingdom may be in danger of exhausting current treatment options, says a paper published online by the British Medical Journal (BMJ) today.

Highly active antiretroviral therapy (HAART) has had a dramatic impact on the health of individuals infected with HIV. But some patients experience problems while receiving HAART and may have to switch drugs on one or more occasions, raising the concern that these patients may exhaust all currently available treatment options.

Researchers at six large HIV centers in southeast England monitored 16,593 individuals who had attended one of the centers for care between 1996 and 2002. They found that, although patients infected with HIV are becoming increasingly exposed to different antiretroviral treatments over time, immunological and virological profiles of these patients continue to improve.

Currently, little evidence exists to indicate that a large proportion of patients are starting to experience therapeutic failure, say the authors. However, for a small number, treatment options are in danger of becoming exhausted. New drugs with low toxicity, which are not associated with cross resistance to existing drugs, are urgently needed for such patients, they conclude.