Dr. Henry, You mention that HIV therapy is very good and getting better. From you prospective, what is the most exciting developement for future tolerability and effectiveness? Also, if your answer dosen't include Maturation Inhibitors, I'm curious to see what your feeling is about that class of drugs. I understand this is slightly off the subject from your forum but I am very interested in getting your opinion.

In my practice (inner city county hospital with large number of immigrant patients) most patients are now doing well with the drugs we have available but the biggest problems are psycho/social/economic with mental health worries, access to treatment concerns, chemical dependency problems more of a issue for their HIV treatment then the drug-related problems. I think drug regimen will continue to be developed with once a day dosing, low pill burdens, lower metabolic side effect profiles, and better gut tolerability. For patients with resistance problems, new classes of drugs will hopefully address that problem (maturation inhibitors as you mention, integrase inhibitors, and numerous chemokine receptor inhibitors as well as drugs from currently available classes that are active against resistant virus). I spend more time on the psycho-social and access problems with patients then I do on antiretroviral matters these days. I don't have any personal experience with the maturation inhibitor from Panacos that is under development to comment on its tolerability or place in the therapeutic repetoire. KH