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FUZEON EFFICACY PERIOD
Jun 27, 2005

DEAR DON, IT IS GOOD TO KNOW THAT FUZEON IS WORKING WELL ENOUGH IN TRACKING DOWN THE VIRUS . BUT MY Q IS, FOR A FUZEON NAIVE PATIENT ,HOW MANY YEARS IT WILL WORK BEFORE THE VIRUS TURNS FUZEON RESISTANT? WHAT IS UR PRACTICAL EXPERIENCE ABOUT fuzeon efficacy period WHEN U TREATED UR PATIENTS?

SAME Q ARISES ABOUT OTHER CURRENTLY AVAILABLE REGIMENS. HOW LONG A PATIENT CAN USE 1ST REGIMEN WITH NRTI n NNRTIs BEFORE DRUG RESISTANCE APPEARS? FOR 4 OR 5 YEARS ONLY OR LONGER THAN THAT? I HAVE HEARD OF A PATIENT IN BOMBAY, WHO IS STILL USING 2 NRTIs n 1 NNRTI REGIMEN (STAVUDINE+ LAMIVUDINE+ NEVIRAPINE) FOR 8 YEARS AFTER HE WAS DIAGNOSED TO HAVE HIV. ALSO I HAVE Q ABOUT PROTEASE INHIBITORS EFFICACY PERIOD.

ANOTHER Q IS, ADEFOVIR IS A NUCLEOTIDE ANALOGUE. IS IT USED IN ANY HAART REGIMEN POPULARLY? IF NOT, WHY?

TODAY I FINISH HERE. HAVE GOOD HEALTH n MIND. KEEP IN TOUCH. THANK U TITAS, MBBS STUDENT,INDIA

Response from Mr. Kurtyka

Titas,

Fuzeon is like other antiretroviral agents in that there are MANY things that can influence how long it will remain active (or conversely, how long it takes resistance to develop). Some of these factors are the individual's adherence to the agents, availability of other active drugs used in the regimen combination, other factors that could affect drug levels such as malaborption, the potential for the patient to "inherit" additional resistance via unprotected sexual activity or needle-sharing, etc. I have seen patients have great virologic and immunologic response from Fuzeon-based regimens with no signs of resistance. But I have also seen patients rebound shortly after initiation of Fuzeon in a regimen, most likely when other active agents were not used in the combination.

Adefovir is indeed a nucleotide analog. It was initially planned as an antiretroviral drug for treatment of HIV. In the doses needed for HIV treatment, it was renally toxic and did not get approved for HIV treatment. In a much lower dose it is now approved for treatment of hepatitis B.

-dk


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