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phase II medications: will they ever make it?
Jun 8, 2004

Dr. Gerald,

What I am questioning here is what I refer to as a new kind of hiv medication that has much less side effects such lipodystrophy, lipoatrophy, liver toxicity, and very importantly much more potentcy which makes resistance more difficult to occur. I for the time being will call these Phase II drugs. Today's hiv drugs are problematic, full of complications to the patient, and often fail causing the patient to die in a limited amount of time. When will new drugs emerge that address these issues successfully? Do you think 5, 10, 20, or 50 years time? It is unfortunate that hiv has almost become cancersized when today some cancer patients can be cured and this is not the case with hiv, and in the end most if not all will die from complications of the virus. What is your outake? Thank you.

John Roberts

Response from Dr. Pierone

Yes, we need new agents that have no side effects and are impervious to the development of viral resistance.

I suspect that we will continue to see small incremental advances in therapy and occasional leaps forward. I must highlight the fact that front-line medications of 2004 are vastly better than those available in 1999. So in the last 5 years these incremental advances have resulted in major progress.

The best is yet to come, but exactly when the leap forward will occur is unpredictable. My sense is that some surprising advance in immune based or vaccine approach may be the next leap, but perhaps not.

A better analogy for HIV might be diabetes. We don't generally cure diabetes, but we keep people going for decades with medications. Not to state the obvious, but a cure would be better. Thanks for posting.



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