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The future....
Mar 2, 2005

Dear Ben.

I wanted to ask how you see the future of therapy over the next few years.

I have seen a lot in the press of late regarding CCR5 inhibitors - do you envisage these will take over from the existing combination therapies on offer, or will they be used in conjunction with the therapies. Also, are they designed more in mind for people who have encountered drug resistance rather than treatment naive patients? Also, how far away are they from being offered as treatments?

Another reason for contacting you is to ask how far away you believe a therapeutic vaccine is, which will halt the progression to AIDS, and what form this may take?

Sorry for so many questions, but I need to know that there is a glimmer of hope.

I would like to finish by saying what a fantastic web site this - I am a gentleman living in England, and we do not currently have anything like The Body over here.

Many thanks.

Howard.

Response from Dr. Young

Thanks for your post. While our site is based in the US, there's no particular reason why UK readers can't benefit.

CCR5 inhibitors indeed are getting a lot of press these days-- we have several compounds in advanced clinical studies (including compounds from Schering, Pfizer and GlaxoSmithKline, to name just a few). The compounds are exciting from the standpoint of having a good tolerability and potency in patients who already have some measure of drug resistance (they're probably on par with protease inhibitors for potency). There are still significant developmental issues that will need to be addressed, such as long-term tolerability and safety, but there is excitement about their potential. Since several of the drugs either are in or are about to begin their pivotal phase 3 studies, I'd think it a safe bet that we'll probably see one of these drugs on the market within 1-2 years.

As for a therapeutic vaccine, I think that in the near-term future, the prospects of having one are unlikely. Typically vaccine research goes from target selection to proof of concept studies within 5-10 years. As an example of this, we now have candidate vaccines for Ebola and SARS that are in varying degrees of evaluation. In the same period of time (and quite a bit more), we've seen 5 different classes of HIV antiretrovirals, but we have languished in the absence of significant breakthroughs with therapeutic vaccines for HIV. Not for the lack of trying, but rather, that the lifestyle of HIV and it's rapid mutation rates make it a tricky target for vaccine development. I'm hoping for a breakthrough, but I'm also not holding my breath on this front.

So, I hope this answers some of your questions. Thanks for reading and your words of support.

Cheers, BY



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