Efficacy of AIDS Drugs Ebbing

"We could be right back where we were in 1984, when the virus was unstoppable," said Larry Kessler, executive director of Boston's AIDS Action Committee, of the news that the vast majority of US HIV patients carry a form of the disease able to resist one or more HIV drugs. The study, released this week at the American Society of Microbiology conference in Chicago, reported that 78 percent of the patients tracked developed resistance to at least one of the 15 AIDS drugs available.

"This is something that we really have been worrying about, dreading," Kessler said. He had assumed, based on smaller previous studies, that one in four HIV cases were resistant rather than three in four, as the new study indicates. The study suggests that a new generation of patients might not have the luxury of trying different drug combinations, and that older patients, who have cycled through many medications, are running out of time.

"If I should happen to fail the cocktail I'm taking, I don't know where to go," said Charles Lacombe, 53, of Boston, whose HIV is resistant to most AIDS drugs. Diagnosed with HIV in 1992, Lacombe began taking three AIDS drugs, including the protease inhibitor crixivan and AZT in 1995. But the side effects -- pancreas damage, kidney stones and fatty deposits -- were so severe that his doctor put him on new drugs. Almost immediately after the first drug combination was cut off, his HIV became resistant to all protease inhibitors, AZT and a third class of drugs. His current regimen might be the last effective combination, he said. But many of the gay men he socializes with continue to believe AIDS drugs offer lifetime protection. "People are back to the same old practices that started this epidemic anyway," Lacombe said.

Dr. Ronald Valdiserri, deputy chief of STDs at the CDC, had similar concerns and said the new study "underscores the importance of prevention" of new infections.

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