 |
|||
 |
Are treatments effective on other subtypes? |
||
| ||||||
Question:Hello. Most of the HIV/AIDS clinical trials are done in the U.S., where HIV-1 Subtype B is the predominant strain. Is there any reason why these new drugs (protease, reverse transcriptase) won't also work for the other strains, including HIV-1 Group M, HIV-2 and the very rare HIV-1 Group O? Are trials/studies being carried out that focus on these other strains? Thanks.Dr. Pavia's Response:Great question. Subtype B strains are also predominant in Europe, Canada, and Australia, where other major clinical trials are done. A smattering of other subtypes are increasingly turning up in the "developed" countries, and some patients infected with non-B subtypes are probably enrolled in modern trials (although we usually don't know).There are significant differences in reverse transcriptase between HIV-1 and HIV-2 which may effect treatment response. I am not aware of any consistently reported differences in protease or RT between HIV-1 subtype B and the other major subtypes (A and E being among the most important) that would predict differences in treatment response. However, only clinical trials will really answer this question. Increasingly, trials are being done in Latin America (especially Brazil) and Thailand, which will give us some answers. Andrew T. Pavia, MD |
