AIDS Drugs Help, But Not Enough

Another aims to stop the viral enzyme integrase, which allows the virus to incorporate itself into the chromosomes of cells and perpetuate its presence in the infected person.

"If we have enough targets, we may be able to completely cripple the virus," says Kevin Robert Frost, vice president of clinical research and prevention programs at the American Foundation for AIDS Research, started in 1985.

"And if we have a broad enough armamentarium, over time, even if resistance develops there will be some virus still sensitive to a drug on the shelf that hasn't already been used."

The Pharmaceutical Research and Manufacturers of America says a little more than 100 new drugs are in testing either against the virus that causes AIDS or its resulting opportunistic infections. Currently 64 drugs have been approved, with either direct antiviral or other capabilities.

Most experts do not look to vaccines as the hope to stop AIDS in the near term. They say an effective vaccine might be another decade away.

Recent results in monkeys with a vaccine approach called "prime boost" — involving naked DNA containing HIV genes and a booster shot of another virus genetically engineered with HIV genes — have been promising, says Mark Harrington, of the Treatment Action Group, an organization that lobbies for more AIDS research and treatments.

The animals were not protected from getting infected, but they did not get as ill, he says. It could take another 10 years before this vaccine goes through the process of clinical trials to reach humans, if it even works, he says.

Delaying Treatment

In 1996, early results from the protease inhibitors made the AIDS community believe that if patients took the drugs earlier, they might be able to eradicate the virus from their system. The federal government endorsed this approach in its treatment guidelines for the disease.

But in February, the federal government changed its policy regarding early treatment with protease inhibitors. It is now recommended that people wait until they become sicker before taking these drugs.

Less ill people can delay their potential exposure to side effects since to stay healthy people will probably need to take the drugs for the rest of their lives.

Lewis-Thornton is concerned that some people have become complacent about AIDS, believing that drugs are making it a manageable disease. She has been able to survive with AIDS but knows many people who have died. A total of more than 438,000 people in the United States have died from AIDS.

"People are naïve to think that AIDS cannot happen to you and that if it does, it's no big deal," says Lewis-Thornton. "HIV treatment requires a lot of work. I tell young people it is a burden they really don't want to have. If I didn't have HIV my life would have been completely different."

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