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Simplest therapeutic regimen found less effective against HIV

by Medindia Content Team on Oct 14 2005 4:14 PM

Antiretroviral therapy for treatment of Human Immunodeficiency Virus type 1 (HIV-1) infection has improved steadily since the advent of combination therapy in 1996. More recently, new drugs have been approved, offering added dosing convenience and improved safety profiles, while some previously popular drugs are being used less often as their drawbacks become better defined. Resistance testing is used more commonly in clinical practice and interactions among antiretroviral agents and with other drugs have become more complex. New government guidelines recommend against starting AIDS patients on a popular treatment combination, due to concerns that using two similar drugs can rapidly lead to treatment-resistant strains of HIV.

Therapeutic regimen that combines Videx and Viread with so-called "non-nuke" drugs like Sustiva is one of several treatment groupings that have led to the dramatic turn around against AIDS. In comparison to a litany of pills that HIV patients have to swallow to keep the virus under control, Videx and Viread, are a lot simpler to use, as they have to be taken just once a day.

However, recent studies have shown that HIV quickly grows resistant to the drugs when all three are used at once, possibly because Videx and Viread attack the disease in a like-minded fashion, and so, the Department of Health and Human Services is urging newly diagnosed patients to relinquish therapies that specifically combine these three. The new ‘Guidelines for the use of antiretroviral agents in HIV-1-infected adults and adolescents’ have been published, dated October 6, 2005.

Dr. Roy Gulick, an HIV specialist who helped establish the new guidelines, states that when two similar drugs are used together, they tend to mimic each other and fail. Despite falling short initially, Gulick said that the combination could still be used if other options prove unsuccessful. The new guidelines reflect the broad choice in AIDS treatment, listing the pros and cons for each, while suggesting that doctors and patients pick a regimen that best fits their needs.

While at present there are more than 20 HIV drugs that fall under four broad categories, with an almost infinite number of combinations, the best regimens suggested are those that attack the disease from different angles.


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