Keeping It Real
Don't Believe Everything You Read
We all suffer from what has become known as TMI -- too much information. Our televisions, magazines, newspapers, computers, cell phones, fax machines, etc. have provided us with TMI. This includes the area of HIV treatment. One reason there is so much information is because there is a lot happening. Much research is being done worldwide, including the development of promising new drugs in the "pipeline." Some large-scale studies are underway, such as "SMART" (Strategies for Management of Anti-Retroviral Therapy) that will provide invaluable answers about crucial treatment issues. "SMART" and other studies will help answer the most important question we have: "How do we best use the HIV drugs available to increase the lifespan of people with HIV/AIDS?"
To look at this question, there are a couple of reference points that may come in handy. First, relative to other diseases the world has faced, the treatment of HIV infection is now just approaching its "adolescence." What I mean is that when doctors treat other diseases (for example, cancer, diabetes, or heart disease), they have 30 or more years of studies to guide their treatment decisions. With HIV, we are just starting to get good information about patients treated for 8 years or more. Secondly, the challenges that face the physician specializing in HIV are formidable. For its community forums, The Center for AIDS recruits the "best and the brightest" HIV-treating physicians. I'm amazed at their honesty when they simply have to answer a question with, "I don't know." I have such respect for these physicians and their impossible task of overseeing HIV treatment.
Further complicating treatment decisions are the HIV treatment "philosophies" that seem to change almost as often as the weather. Some of these have been developed as the result of sound research, such as the switch from "hit hard, hit early" to "monitor and wait to treat." Others, despite being widely known thanks to the Internet and other media, are not nearly as well founded.
In the last few weeks, you may have seen information regarding the triple nuke medication Trizivir, the single pill that combines Retrovir, Epivir, and Ziagen. Information distributed through a press release and advertisements from the Los Angeles-based AIDS Healthcare Foundation included a bold headline proclaiming, "Trizivir is Dangerous."
We were stumped. The FDA doesn't approve drugs that are "dangerous." Do they often approve drugs that are difficult to take? Yes. What about drugs that have side effects? Yes. What about drugs that have varying levels of effectiveness in treating HIV? Yes. Anyone taking HIV meds know that there are benefits and pitfalls for each pill that is popped. The problem is this: in the midst of our "information overload," we see such news reports and immediately think, "Oh my God, my doctor doesn't know what he's doing and is trying to kill me!" Newsflash: that's not what's happening.
Trizivir has been approved as a combination medication since November 2000. Its component drugs Retrovir, Epivir, and Ziagen have been in use since 1987, 1995, and 1998, respectively. Of course there are limitations to this medication. Everyone should be aware of the side effects from each of the drugs contained in Trizivir, some of which can be serious (including "hypersensitivity," a dangerous kind of allergic reaction to Ziagen). Additionally, Trizivir isn't the biggest bully against HIV on the medication playground -- it is not the best (most powerful) treatment if you have a viral load of over 100,000. That said, there is a place for this medication in the spectrum of treatment options available for people with HIV. It definitely is an option for some people with HIV; that is something to work out with your doctor.
Do its limitations make Trizivir "dangerous?" Hardly. Should you use common sense when reading medication package inserts for HIV drugs, as well as press releases or advertisements issued by AIDS Healthcare Foundation? Always!
This article was provided by The Center for AIDS. It is a part of the publication HIV Treatment ALERTS!. Visit CFA's website to find out more about their activities and publications.