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Any new drugs
Oct 23, 2000

Have been + and on meds for 11 years. Took the newest resistance test and the only drugs that show hiv resistance are zerit and videx. Have taken everything there is so far. Is there anything new on the horizon.

Response from Dr. Pavia

There is lots on the horizon. The question is what is close, and what will make it here. There are other good places to look for information on new drugs, including the summaries of conferences on this site and on Medscape. Here's a short rundown of a selected few.

Kaletra (lopinavir/ritonavir) was just licensed. It is active against many but not all protease resistant virus. However, it must be partnered with some other effective drugs. Don't run out and use the latest drugs one at a time or you'll waste them.

Tenofovir is in a limited expanded access program. It is a nucleotide in late development and is active against many resistant viruses. It could be paired up with other drugs to help build a regimen.

T20 is an injectable drug that must be used twice a day. It works by a new mechanism, blocking the entry of virus into cells. There are phase 3 trials starting up which will combine it with other new drugs. Check one of the trial finder sites or talk with your ASO and your doctors. Several other entry inhibitors are in early development.

DAPD is a new nucleoside that is active against many strains resistant to AZT, 3TC and the D drugs. It is in early trials but looks like a good bet to make it.

New protease inhibitors are in phase two trials. One is from BMS and looks like a once a day drug. Another, tipranavir, is now being developed by Boeringer and is active against most PI resistant virus.

So, there is a lot of potential out there. Take stock of where you are though, because often it is reasonable to stay on drugs that are only partially active to maintain your CD4 count until there are enough new drugs to put together a regimen. Make sure to talk this over with your doctors and this is a situation where experience counts, and it helps to have docs who do a lot of treatment of long timers, like you. Good luck

ATP

Andrew T. Pavia, M.D.



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