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Managing Side Effects of HIV TreatmentManaging Side Effects of HIV Treatment
           
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who is more likely to have severe side effects
Jul 12, 2004

Have any studies been done about genetic tests that might help to determine who is likely to have severe reactions such as pancreatis or rash to particular medications?

Also, given their lower level of side effects, why aren't entry inhibitors such as Fuzeon recommended as first line therapy?

Response from Dr. Conway

With respect to the issue of genetic predisposition to side effects, there are specific HLA (immune marker) associations with abacavir hypersensitivity and possibly some of the more serious side effects associated with nevirapine. The information on nevirapine (an association with HLA-DRB1*01) will be presented at the AIDS Conference in Thailand this Thursday.

None of these tests are yet reliable enough to be used in the general population to help predict, before starting therapy, who will (or will not) develop any side effects.

As for Fuzeon, the problem is that it is an injection (rather than a pill), it must be given twice a day and it is MUCH more expensive than the other medications currently available. With respect to side effects, as many as 3% of people who take it will get pneumonia (we don't know why). Also, 90% will develop some sort of injection site reactions, although they are only severe in a few percent of cases. If you look at all of this information as a whole, you can see that other options for initial therapy are available. In more treatment experienced patients, Fuzeon is often an excellent choice, that makes the difference between success and failure.



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