Currently approved anti-HIV drug combinations are remarkably effective at reducing the amount of HIV in many patients to undetectable blood levels. For most, the clinical benefits add up to a healthier, longer life. Yet two studies in this week's New England Journal of Medicine demonstrate that, as good as these drugs are at suppressing HIV, other approaches likely will be needed to knock out the last vestiges of the virus.
"These findings are not unexpected," comments Anthony S. Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), which provided major support for both studies. "The data add to other recent findings indicating that it may be impossible to eradicate HIV from the body with currently approved antiretroviral therapy. What all these studies underscore is the pressing need to develop more effective, less toxic medications that can be used over the long term to suppress HIV, as well as novel strategies to then purge residual virus from the body and boost the immune system. In this regard, many important leads are being pursued by investigators in government, academia and industry."
The era of highly active antiretroviral therapy, or HAART, began about three years ago when the first protease inhibitors were incorporated into multi-drug HIV treatment regimens that included older anti-HIV drugs such as AZT. Hopes that the drugs could "cure" AIDS were raised when some patients experienced dramatic drops in the level of HIV in their plasma. More sophisticated studies, however, subsequently turned up evidence that some virus survived the therapy by hiding in certain cells and tissues.
The NEJM studies were conducted by separate groups of investigators from the
Aaron Diamond AIDS Research Center in New York, led by Linqui Zhang, Ph.D., and
David Ho, M.D., and from Northwestern University Medical School in Chicago, led
by Manohar Furtado, Ph.D., and Steven Wolinsky, M.D. Both groups focused
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Contact: Laurie K. Doepel
ldoepel@nih.gov
301-402-1663
NIH/National Institute of Allergy and Infectious Diseases
26-May-1999