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What's on the Horizon
Apr 16, 2006

Good Day doctor, I was diagnosed with HIV about two weeks ago. I don't know yet if I'll need any meds. I know treatment has come a long way since the early days of this disease. Can you please tell me what's next in terms of treatement for this virus. What new medications are being developed? Can we expect even more effective/potent drugs in the near future? Are we moving toward drugs that will definitvely halt progression of HIV inside the body? When can we expect these drugs to appear on the market? How close are we to a cure?

I believe I was infected within the past year and I just want to know how much hope I should have that future treatments will make it more likely that I will live the high-quality life and have a normal life span I always assumed I would.

Thank you and I look forward to your response.

Response from Dr. Daar

Good day to you as well.

Obviously finding out one is HIV-infected is never good news. However, once over the initial reaction it is important to note that if it had to happen, now is a good time. The treatment options currently available are really excellent. Although not a cure, they do offer most people simple, well tolerated and highly effective therapy. It sometimes takes a little work to find out the best regimen for any given person, but once identified most people who take their treatment will enjoy many years, if not a life-time of undetectable viral loads with strong immune systems.

While only time will tell, many experts (including me) believe that currently available therapies already "definitively halt progression of HIV" in many people. I would argue that even if we are wrong and these treatments do not continue to suppress virus forever, there are so many options already available, and in the pipeline that there is good reason to remain extremely optimistic.

As far as what is next. Well there are many drugs in development that will provide options for those with drug resistant virus, clearly the Achilles heal of therapy. This includes new protease inhibitors recently approved, such as tipranavir (AptivusTM) and in expanded access with anticipated approval in the coming months TMC114 (darunavir). There are also promising NNRTIs that may provide options for those with drug resistance.

Drugs with novel targets of action are in development and at least preliminarily look promising. These include those that block an early step in the viral life cycle, so called CCR5 inhibitors. In addition, integrase inhibitors are also moving forward in clinical trials. These types of agents will offer options for those with resistance to existing classes as well as potentially change what types of therapy being used in those who have never been on treatment before, such as you.

The new drugs are exciting, but you need to know that currently available agents will likely already provide you with that "normal life span" you always assumed you would have.

All the best, Eric


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