The Body Covers: The 39th Annual Meeting of the Interscience Conference on Antimicrobial Agents and Chemotherapy
Session 93.I: Late-Breaker Slide Session II
September 27, 1999
This study is a follow up to the information presented earlier in 1999 at which we learned of the ability of a new class of drug to work against HIV. T-20 is the first example of a drug that is active in the class known as fusion inhibitors -- these drugs prevent HIV from attaching onto cells. If HIV cannot attach on to a cell, it does not insert its RNA into the cell, and this prevents HIV from using that cell as a "virus factory". Since HIV does not live more than a day outside of the cell, a drug that is active in blocking HIV from gaining entry into a cell would be very helpful in controlling this infection. Also, because it is a new class of drugs, HIV that has become resistant to the current classes of drugs should still be fully sensitive to T-20. At a conference earlier in 1999 (Retrovirus conference), we saw the first month results which showed that at the higher doses tested, HIV viral load could be reduced by over one log when added as a single drug to any background therapy in people with multidrug resistant HIV. This presentation was the follow up to that study. That study also showed that this drug could be used as a subcutaneous injection given twice a day.Abstract: Sixteen Week Analyses of Heavily Pretreated Patients Receiving T-20 as a Component of Multidrug Salvage Therapy
Here, T-20 was used, and all patients were also given a genotype test to guide what could be given from the available antiviral agents. This group was heavily exposed to all available agents, and the results of the genotype demonstrated that virtually all participants had resistance to all three classes (nucleosides, nonnucleosides, and protease inhibitors) of antivirals. Despite this high level resistance, 60% of the participants achieved at least a one log drop in viral load at week 16, which appeared to be stable over the preceding weeks. Further, about 36% had a viral load below 400 copies, while about 20% achieved a viral load below 50 copies. Since all participants had received T-20 in their regimen there is no clear demonstration of the role of t-20, except that these results appear to be better than what is generally seen in studies that address the needs of this heavily treated group. Similarly, the results here were not due to simply giving more antivirals, as the results held up no matter how many standard antivirals were used along with the t-20.
Further studies are being done to further characterize T-20, but these results suggest that the first member of a new class of agents is on the way, with much needed activity against the HIV strains now most difficult to treat. As a component of a new "cocktail", T-20 may be a key agent for those with resistance to the current medications.
Authored by: J. Lalezari, J. Eron, M. Carlson et al.
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