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Drugs are failing -- what is new on the horizon?
Apr 10, 2000

Dear Dr. Holodniy,

I have been living with AIDS for over eight years, HIV+ for 15/16 years. I have done every medication on the market at least once many twice and three times. I waited almost three years for three new drugs in three different categories. I have had many OI's over the years and serious side effects to meds. The current comb was started about a year ago. The current combo is Sustiva, Abacavir, Agenerase, and Norvir (not new to me). I have never obtained an undetectable VL. I have been doing HIV/AIDS's meds since July 1991. I understand I am a heavily pre-treated patient with medications. I have always treated HIV/AIDS aggressively and used meds as soon as they were approved as well as I have been in 4 clinical trials over the years. The lowest VL I have been down to is 571 (6/23/99) 15%, t-cells at 244. I have been seeing a rise in the vl and a slight drop in the t-cells since then. As of 3/17/00, VL 12,000, t-cells 203. It appears that this combo is starting to fail. The longest any combo has worked is about a year or so. The highest my VL has been is 1.5 million and the lowest my t-cells have been are 33, 5%. In the last year my health has increased dramatically for the better. In fact I am in the best health I have been in for over 6 years.

My questions are as follows: 1) What new meds are in the pipeline that would help a heavily pre-treated patient like myself? 2) What use is a resistance test for me and when do you suggest having one done? 3) Are there any trials for someone like myself that is so heavily pre-treated?

Thank you! Sorry if I sound a bit frantic. But I feel like I am again at the end of my rope. I don't think I could wait again another 3 years for new meds.

Jack

Response from Dr. Holodniy

Congrats! You are a survivor. You are still better off today, even with a detectable viral load, given where your numbers were and where they are now. Several new meds are in the pipeline. ABT-378 and tenofavir are available through compassionate use protocols. A resistance test should be done now when you are receiving a regimen. It would be useful, because it will tell you and your doc what not to use. A useful website for trials is: www.actis.org.

MH


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