January #43 : A Crystal Ball For Drug Success - by Lark Lands

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The Fire This Time

Rainey on Parade

The Mayor of Market Street

The Best, Worst & Weirdest 1998

Numb and Number

Love's Recovery

Back on His Feet

Say What


Two Nations Under Plague

The Black Death

To The Editor

Research for the New Millennium

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Letter from Manila: The Wages of Sin

Vials of the Dolls

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Comply or Die

Vaccine Vexations

Bad News Bear

AIDS on the Net

A Crystal Ball For Drug Success

Backing off Bactrim

Vits Against Virus

Reinfection Revisited

Waste No Time

On Your Feet

Sean's Sugar Highs

Black Power

Where to Find It

Checking In: Food For Thought

Aunt Evelyn's Letters

The Price Wars

Most Popular Lessons

The HIV Life Cycle


Herpes Simplex Virus

Syphilis & Neurosyphilis

Treatments for Opportunistic Infections (OIs)

What is AIDS & HIV?

Hepatitis & HIV

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January 1999

A Crystal Ball For Drug Success

by Lark Lands

Staying on an anti-HIV combo until it fails increases the risk of cross-resistance to future therapies, so early indicators of drug failure are urgently needed. Recent findings from a study by Agouron (maker of nelfinavir [Viracept]) found three variables that predicted who would do well—both initially and over the long haul—on a nelfinavir/AZT/3TC  combination: baseline viral load, the change in virus at four weeks and the blood concentration of nelfinavir (but not AZT; 3TC data is still being analyzed). While each had significant predictive value when used alone, their combined power was more striking: 93 percent of people in whom all three predictors were positive (a baseline viral load under 162,000, at least a 2.35-log drop in viral load, and a nefinavir drug level of at least 1.9 mg/liter two hours after dosing) responded well to the drug therapy. People with no positive predictors responded very poorly to the meds; those with one or two positives fell somewhere in between. If future trials confirm these preliminary findings (not yet ready for prime time), PWAs may have a powerful new tool to help to design treatment strategies. By identifying early those at high risk of combo failure, changes could be quickly implemented, greatly improving the chances of long-term success. 

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