May 29, 2003
If three or four meds, which is the current recommendation, can do such a good job of suppressing HIV as opposed to just one, then why not use six or eight? Maybe ultra aggressive teatment would get to the 'hiding' HIV that is currently so difficult to get at. Could this realistically even be attempted, and are yu aware of any trials doing so? (I think I heard Dr. Ho in NY is looking into this, maybe not with 6-8 meds, though). The biggest reasons this wouldn't work in my mind are: immense side effects, rapid resistance to all drugs if it fails, high cost.
If you could get around these reasons, do you think there could be any benefit to this? Is this question worth asking, or does it reflect my ignorance of the situation? Thanks.
Response from Dr. Wohl
So called mega-HAART or giga-HAART consisting of 5 or more antiretrovirals has been studied, mostly in the treatment of drug resistant HIV. As you mention, the side effects are the major limitation to such an approach.
With more tolerable drugs it may become more feasible to use such multi-drug combos. Alternatively, with more potent agents that are harder to become resistant to, we may find ourselves using fewer drugs than we do now. DW
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