This double issue of ACRIA Update includes discussions of each of the currently approved anti-HIV medications (antiretrovirals). Depending on whether you count new formulations of existing drugs, there are now between nineteen and twenty-one antiretrovirals available in the U.S., including four that were approved in 2003 alone.
Looking at each drug individually is helpful, but it's important to consider them in the context in which they're used -- as components of combination therapy. Keeping this in mind, the overviews in this issue include: background on each drug's development and approval process; significant clinical trial results; possible short and long-term side effects; interactions with other drugs; resistance profiles; safety during pregnancy; dosing; availability for pediatric use; and when the drug might be most beneficial as part of a combination.
Organizationally, the issue groups the drugs by class and discusses the individual drugs in order of their FDA approval within that class. A sense of the history of the development and clinical use of anti-HIV treatment lies within the content and subtext of this issue. We've come a long way since the days when a drug was considered beneficial if there were fewer deaths in the group of people taking it alone than in the group taking another drug.
This issue of ACRIA Update
is intended for people who are considering treatment in the future as well as those who are already on treatment. If you're not on treatment, we hope that the overviews offer a sense of the pros and cons of individual drugs and combinations as you consider what might work best for you if the time comes to begin treatment. If you are on treatment, we hope that these overviews provide you with helpful information about the drugs you're taking. If this issue helps one person suffering from peripheral neuropathy
realize that they don't have to stay on a drug that contributes to that debilitating condition, our efforts have been worthwhile.
We don't expect most people to read through the entire issue -- certainly not in one sitting. If you do, let us know and we'll give you some sort of medal. Rather, use it as a reference guide. You may choose to look at only the background of some of the drugs or maybe just the side effects and drug interactions. If you feel overwhelmed or discouraged as you read the side effect and interaction sections, it's important to remember that we've listed the possible side effects -- no one experiences every possible side effect of a drug. And many people don't experience any.
We dedicate this double issue of ACRIA Update to the individuals who have participated in -- and continue to participate in -- clinical trials that give us all a better understanding of HIV disease and its treatments. Thanks to their participation in research, we're able to provide this overview of nineteen to twenty-one antiretrovirals, a far cry from what we would have been able to provide in 1987 when the first antiretroviral was approved.
This issue of ACRIA Update was a collaborative effort, researched and written by: James Learned, ACRIA's Director of Treatment Education and Editor of ACRIA Update; Mark Milano, treatment educator at ACRIA and longtime AIDS treatment activist; and Donna M. Kaminski, ACRIA's Associate Director of Treatment Education.
Special thanks to Tim Horn for his editorial review of some of the contents of this issue.