HIV pathogenesis and treatment strategies

Article Abstract:

Early drug therapy for HIV infection should involve a combination of antiretroviral drugs to capitalize on a functioning immune system. The fact that HIV infection remains active over the course of the disease should encourage early administration of combination drugs, especially in view of drug resistance to zidovudine (AZT). Since the body produces a high rate of virus every day, introducing strong antiretroviral drugs is an attempt at stopping continuous viral production. The availability of additional antiretroviral drugs, such as lamivudine, can reverse resistance to AZT at emerging mutations. Drug therapy will be most effective at controlling the virus in concert with the body's own intact immune system. Selecting therapeutic drugs should be based on individual tolerance, resistance, antiviral synergy, and related cell activity.

Antiviral agents

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Rationale and experience with reverse transcriptase inhibitors and protease inhibitors

Article Abstract:

Effective drug treatment of HIV infection could combine the benefits of protease inhibitors with reverse transcriptase inhibitors (RT), such as zidovudine (AZT). Protease inhibitors include MK 639, ABT-538, Ro 31 8959, and VX 478. Most of the antiretroviral drugs inhibit the HIV reverse transcriptase enzyme, but research on other enzymes, such as protease, looks promising. Protease inhibitors effectively interrupt viral spread by generating immature virus particles. Because of the risk of emerging resistance to protease inhibitors, the use of RT inhibitors in combination with protease inhibitors looks very promising. High-dose combinations of AZT and saquinavir reduce viral load close to 98%, an effect superior to that of either drug taken alone. Lower doses of saquinavir are less effective than the optimal dose of 600 milligrams.

Research, Protease inhibitors

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Survival in 2367 zidovudine-treated patients according to use of other nucleoside drugs

Article Abstract:

A large European study has found that HIV patients who take other AIDS drugs in addition to zidovudine may survive longer. Researchers followed 2,367 HIV patients who were treated at 37 medical centers in 16 European countries beginning in May 1994. All were taking zidovudine and one other drug, including didanosine, zalcitabine, stavudine, or lamivudine. Mortality rates were lower in patients who took one other drug at the time they began zidovudine or shortly thereafter. Lamivudine in particular was associated with greater survival rates than the other drugs when used with zidovudine.

Lamivudine, Didanosine, Zalcitabine

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