Tips from November’s ICAAC—the last of 2004’s big three HIV science and treatment confabs
Drugs we have Early results in a two-nuke face-off show Emtriva and Viread—debuting elsewhere as Truvada—licking longtime nuke duo Combivir (AZT/3TC) in efficacy and side effects. Plus, over 11 months, the four-nuke combo of twice-daily Trizivir (AZT/3TC/ Ziagen) and once-daily Viread worked as well in first-time HAART takers, as the proven Combivir/Sustiva mix. Quad-ruple-nuke cocktails, anyone?
Drugs we need HIVers with heavy resistance to protease inhibitors (PIs) did better if their combos included soon-to-be-released PI tipranavir (TPV) than any other PI. Those who paired TPV with Fuzeon (T-20) did best—nearly half got their viral loads below 400. Moral of the story: If you’ve been around the protease block, save Fuzeon until you can snag some TPV (now in expanded access) to double-barrel it with.
Treatment tricks One study tested 10 HAART-takers’ viral loads three times a week and found that brief “blips” of low detectable virus were common but not dangerous. Another discovered that HIVers who’d taken drug holidays from Sustiva or Viramune combos were more likely to show resistance when they went back on those non-nukes than those who took breaks from protease-inhibitor combos and later returned to them.
Coinfection treats In HIVers coinfected with hepatitits C, pegylated interferon plus ribavirin achieved six-month response rates equal to those seen in folks with hep C alone—even if coinfectees had notoriously hard-to-treat hepatitis C genotype 1. Researchers credit the higher doses of riba-virin used in the study for the better-than-usual results. That’s OK—but we still want our up-and-coming hep C protease inhibitors!