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question regarding novel class of antiretrovirals
Apr 2, 2005

hey bob, i really admire ur work here and i'm happy to see that HIV is becoming more and more "acceptable" in our society.i know this is not the place to ask the question but u're really cool and seem to know what u're talking about.i'm not HIV positive but i think that this disease is the PANDORA box of our society and knowing that something as beautiful as making love can become a lethal death penalty is really shocking.enough with the romantic perspective.let's talk about something tangible.i have been following the tibotec compounds TMC 125, 114 and 278 since they first appeared on the horizon of therapy.i know that they have a superior resistance profile , more potency and a lower risk for side effects.i just want to know how HARD it is for resistance to emerge with the TMC compounds+ i wanna know more about their side effects and potency.i've been searching the net but i don't really understand all the contradicting ideas that surface.thx man i really appreciate it.

Response from Dr. Frascino

Hi,

Well I'm not sure I agree with your premise that HIV is becoming more "acceptable" in our society, even though there are today 40 million of us living with the virus. But that's a discussion for another time.

Regarding the Tibotec compounds, you are correct, this is not the place to pose those types of questions. So that is a discussion for another place! Briefly, the reason you are having difficulty finding detailed information about their resistance profiles, side effects and potency compared to other agents is that these drugs are still in development. Consequently, we are all still learning.

I should mention for our readers who have not heard about these compounds that Tibotec (a division of Johnson and Johnson) is developing an NNRTI (TMC-125) and protease inhibitor (TMC-114) almost in parallel. Preliminary information indicates these drugs may well be effective in folks already NNRTI- and protease inhibitor-resistant.

TMC-125 is the leading contender to be the first "next generation" NNRTI. It has a novel structure. Recent data suggest that in terms of resistance it may be bulletproof, but not bomb proof. In other words, it may work well in folks with some degree of NNRTI resistance, but less well in those with select mutations that may be present in combination.

TMC-114, the new protease inhibitor, also looks promising, particularly when boosted with ritonavir. Impressive data from a phase II clinical trial was presented at the recent CROI 2005 AIDS conference in Boston. Side effects so far have been few, but it is a sulfa-based drug that can induce rash and other allergic responses in some people.

Check The Body's treatment forums for additional information as it evolves. Also, just a reminder, even if Pandora's Box is wide open, you should not enter without proper protection. In the age if AIDS, making love does not have to become a. ("lethal death penalty" Isn't that redundant, by the way?)

Stay safe. Stay well.

Dr. Bob


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