Mar 26, 2012
How do you think the medication pipeline for HIV is looking in 2012. Would you say that it is relatively robust or is it running a little dry ?
Are the any particular medicines that are coming down the pipeline that you think look exciting ?
Thanks for all the hard work you do on this site. Larry
Response from Dr. McGowan
I am a great optimist. There are a few things coming our way: At least 2 more One-pill-a-day combo tablets, a new Integrase Inhibitor that may work when Isentress resistance develops, a new form of tenofovir (our most popular NRTI) that may work at 1/10th the dose, some new attachment inhibitors to stop the virus from penetrating the cell...all good stuff.
What is also exciting is the work being done to try to shrink or eliminate the "viral archive". Which is the few remaining cells in the body that harbor HIV DNA when the viral load is fully suppressed. These residually infected cells are the reason that we cannot stop meds without having the virus regrow and start the whole cycle over again. There are some drugs that may roust out these "latently" infected cells and clean out the archive.
Also some really exciting work on genetically altering CD4 cells to make them resistant to viral infection. This is akin to the Bone Marrow (stem cell) transplant that was done for the patient in Berlin that replaced his bone marrow with marrow from a donor whose cells lacked a key surface receptor for HIV, he has been effectively cured. In the new strategy, you wouldn't need a bone marrow transplant, they would just take your own cells, treat them to modify the gene that makes the receptor so that it is stripped away and give the cells back to you. These cells would grow up and form a population of cells that were impervious to HIV infection...perhaps allowing meds to be stopped at some point!
Very exciting research with some new approaches, thinking outside the box.
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