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FAMILY MEMBER
Jul 1, 2003

MY COUSIN WAS RESISTANT TO TREATMENT AS OF 2001. IS THERE ANY MEDICATIONS THAT HAVE BEEN RELEASED OR BEING RELEASED THAT HAVEN SEEN THE OPPORTUNITY OF CROSS RESISTANCE WITH THE DRUGS FROM 2001 AND BEFORE?

Response from Dr. Young

Yes, there have been a number of newly approved medications-- some are likely to have at least some activity in persons with drug resistance in 2001.

Firstly, enfuvirtide (Fuzeon, T-20) should definately have activity, since it represents an entirely new class of medication.

Additionally, it is possible that using a boosted, or dual-boosted protease inhibitor might be of use. Medications like Kaletra (lopinavir/ritonavir) either alone or in combination with another protease inhibitor would be worth exploration. There is also a new protease inhibitor, tipranavir, that is in clinical trials and very well might have activity against your cousin's virus.

Lastly, a new nucleoside RT inhibitor, tenofovir has been shown to have activity in many drug-resistant variant.

Overall, there is definately reason to reasssess the statement of resistance-- I would caution one in having too much optimism, and also to utilize the best available testing data to assess the likelihood of having active drugs, particularly before embarking on using a new drug class, like enfuvirtide. I typically obtain both a genotypic and phenotypic resistance test to assess the best treatment options for patients like this.

Good luck. BY



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