Dear Dr. Young: It is not my case as I am not yet on meds (CD4: 609-27.8% and VL: 15.232) but there are over 40.000 people suffering Anti-HIV drug failure and desperately waiting for new drugs. What can they do? Am I going to be in the same situation in 15 years time? What are the big pharma companies waiting for to develop new medications? They would make great profits and that is a good motivation. What can these 40.000 people expect from future meds? What can people like me (not on meds yet) expect from the future? Thank you Dr. Young for your valuable an optimistic answers. John (Madrid-Spain)

Hola John--

Thanks for your post.

In actuality, there are probably a lot more patients than just 40,000 who have drug resistance. In the US, it's estimated that as many as 50% of patients may have some measure of resistance. In spite of this gloomy observation, most patients are doing very well; newer options offer viral suppresion with regimens that are often very well tolerated.

The HIV drug pipeline is actually very robust with lots of very encouraging recent data-- take a look at recent data on CCR5- and integrase inhibitors from the 2006 CROI meeting (meeting summaries available on TheBody.com) for a overview.

I also believe that because of increased potency, better tolerabiilty and understanding of adherence that we'll actually see fewer patients failing first- and certainly second-line treatments.

I hope this helps. Buenos suerte. BY