The New Kids on the Block...Kaletra, Videx EC and TrizivirOn September 15, 2000, the FDA approved a new drug from Abbott Laboratories called Kaletra (lopinavir). Kaletra is actually a combination of lopinavir and ritonavir in the same capsule. The addition of the drug ritonavir helps maintain higher blood levels of the protease inhibitor, Kaletra. The most important benefits of Kaletra are its effectiveness against resistant virus as well a slower progression of the virus to become resistant to other protease inhibitors. In addition, Kaletra is very well tolerated by patients when compared to other protease inhibitors. The typical dosage will be 3 capsules taken with food twice a day.
Another new drug now available is actually a combination of three drugs already in use. Trizivir is a combination of Retrovir (AZT; Zidovudine), Epivir (lamivudine; 3TC) and Ziagen (abacavir). Because Trizivir combines three drugs into one tablet, the hope is that it will greatly improve adherence in those patients having difficulty taking several medications several times per day. The recommended dose of Trizivir will be one tablet twice per day.
Finally, an old drug has a new form. Videx EC is the new enteric coated form of Videx (ddi). Because it is enteric coated, it can now be taken with other medications in hopes of improving adherence. The other benefit to Videx EC is that it has been approved for once a day dosing. This too will help adherence. But like the old form of Videx, the new form must be taken on an empty stomach, one hour before or two hours after meals.
What's New in Research?Certain T-cell Proteins May Help Spread HIV
Researches from the National Institute of Allergy and Infectious Disease now report that certain proteins within cells may actually help the disease spread throughout the body. "Housekeeping" proteins within the cell have been found to assist HIV to infect other cells as it circulates in the blood. As HIV leaves the T-cell, it wraps itself in a "stolen" portion of the housekeeping cell's membrane, making it easier to fuse and infect other cells. When scientists prevented HIV from stealing that small portion of membrane, the virus either got caught on the surface of the cell, failing to infect other cells or was not able to mature properly. While more work needs to be done, this discovery may lead to an all new approach to treating HIV.
A Mixed Bag
Scientists have found a gene that apparently slows the progression of HIV infection to AIDS by 40 percent. The bad news is that the presence of this gene makes a person twice as likely to be infected when exposed to HIV. Much more study of this ironic finding needs to be done before benefits if any are realized.
New HIV Mutation
Researchers at Quest Diagnostics report finding another HIV mutation to Nucleoside Reverse Transcriptase Inhibitor (NRTI) drugs such as Combivir, Zerit, and Ziagen among others. The identification of new mutations will allow physicians to better choose new therapy combinations in patients who have resistance. This, in turn, produces a therapy combination that will be effective for the patient.
Blood Marker Linked to HIV/AIDS Survival
Scientists have discovered a link between a substance in the blood and predicted survival when infected with HIV. This blood marker was studied in about 300 HIV infected people. Participants who had high levels of this specific marker were more likely to die during the study period. This incidence of shorter survival was no different in men or women. Identification of this marker in certain individuals may assist physicians in making critical decisions such as when and if to start drug therapy.
Work continues on several fronts to develop an effective and safe AIDS vaccine. Researches have cautioned that a suitable vaccine may be some time coming.