American Foundation for AIDS Research: HIV Treatment-Experienced Patients Set High Standards for Therapy Success
June 2, 2005
Multiple-drug-resistant virus is a growing concern in HIV treatment. A survey commissioned by the American Foundation for AIDS Research (amfAR) found that patients who have failed at least two HIV drug regimens continue to have high standards for their treatment success. They seek to lower their viral loads, raise their CD4 counts, minimize further drug resistance, and choose treatment regimens with the fewest side effects.
The survey findings, presented in April at the 17th National HIV/AIDS Update Conference in Oakland, Calif., emphasize the need for patients and doctors to discuss treatment goals together so they can work to find an appropriate drug regimen.
"Combinations of new drugs that work against drug-resistant virus are now showing response rates previously only observed in first-line therapy," said Calvin Cohen, MD, director of research, Community Research Initiative of New England. "In order for patients to take advantage of these advances, they must actively discuss treatment goals with their HIV-treating physicians so that they can work together to find an appropriate regimen to optimize therapeutic response, possibly including a drug from a new and unique drug class."
The survey showed that 57 percent of physicians and 81 percent of treatment-experienced HIV patients view reaching an undetectable viral load as very important to successful treatment. In comparison, 84 percent of physicians view reaching an undetectable viral load as a very important goal for all HIV patients, regardless of a patient's treatment history. Both patients (88 percent) and physicians (55 percent) view significantly increased CD4 cells as very important to successful treatment.
Current U.S. Department of Health and Human Services HIV treatment guidelines state that the goal for patients who have failed several regimens is "... to resuppress HIV-RNA levels maximally and prevent further selection of resistance mutations." To achieve treatment goals, the guidelines say "adding a drug with a new mechanism of action to an optimized background antiretroviral regimen can add significant antiretroviral activity."
Harris Interactive conducted the patient and physician surveys, interviewing by telephone 115 HIV/AIDS patients 18 or older who took two or more antiretroviral combination therapies, and 150 HIV/AIDS physicians practicing for at least three years. Roche and Trimeris supported the amfAR survey.
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