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What is the least toxic, most durable regimen?
Oct 31, 2002

Hi Docs,

You guys are doing a great job thanks. Anyway, what is the least toxic, most durable regimen? I read that AZT is not good on the bone marrow.

Are we ever going to see better treatments with much LESS toxicity?

Also, is a cure on the horizon, in your honest opinion? Or maybe the real goal now would be 100 suppresive treatment, no resistance and no toxicity, and therefore NO AIDS. I read an article about RNA interference, and it surely sounds promising, as the authors said "this could have implications far greater than HIV/AIDS". Thanks-

Response from Dr. Henry

There is such variability between people that what works well for one person may be a poor choice for the next. That is what makes life interesting but makes broad sweeping generalizations a dicey undertaking. I utilize a wide variety of initial regimens depending on a wide range of factors (disease state, co-morbidities, resistance status, patient preferences, etc.). Many of the simplest current regimens (i.e. Trizivir BID, 3TC/tenofovir/Sustiva q day, Combibir/Sustiva) are well tolerated by most but not all patients. I often tell patients that their is a regimen out there (out of a choice of hundreds) with their name on it (= will work and yet leave them with a smile on their face) and my job with luck and their help is to identify that (sometimes a trial and error process). Cure is unlikely over the next 10 years. Co-existence (tolerated low levels of virus) or long-term suppression (decades) are achievable goals. RNA interference has yet to reach clinical application so we will have to wait on that one. KH



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