Dr. Young: Hi. When several of the fusion and entry inhibitors become a reality for HIV treatment will these agents be taken combination as HAART is today? And will these treatments have a lower toxcidy and resistant profiles than HAART or is it early days yet to perdict the outcome? Thanks for any reply. Justin

Thanks for your question.

Fusion (or entry) inhibitors should make their debut in the near future with the release of enfuvitide (nice name, huh--otherwise known as Fuzeon or T-20). The class of medications is exciting from the perspective that many persons with drug resistance should retain full activity of the new class.

Unfortunately, the drug is very expensive (~$20,000/yr), requires twice daily injections and needs to be taken with at least a couple of other HIV medications. Is it less toxic? The large investigations of the drug have shown it to be relatively well tolerated, with the exception of injection site allergic reactions.

As for future medications, this remains the realm of speculation, since what we'd really want is an oral (pill-form) entry inhibitor. Such compounds are in very early stages of investigation, so we can't really tell you about the potentcy or side effect profile. -BY