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Given recent improvements in antiretroviral therapy, virologic suppression rates now approach 80% or more in most clinics. Achieving this degree of success presupposes infection with susceptible virus, but an increasing number of patients seem to be infected with resistant virus. In a large, collaborative study referred to as CASCADE (Concerted Action on Seroconversion to AIDS and Death in Europe), researchers evaluated rates of transmitted drug resistance among patients diagnosed with acute and recent HIV infection in Europe and Canada between 1987 and 2003. Resistance testing was performed within 18 months of either the last seronegative test or the diagnosis of acute HIV infection.
Of the 438 patients who had undergone genotyping before s…