New HIV drugs urgently needed for HAART patients
HIV viruses are generally responsive to HAART but often develop
resistance |
New drugs that are not associated with cross-resistance are urgently needed for patients on highly active antiretroviral therapy (HAART), researchers say.
They say that the proportion of people in the UK being treated with these
drugs is increasing and, although the general immunological and virological
profile of these patients is improving, there is a significant proportion
of people for whom treatment options may be becoming exhausted.
Using data from six HIV treatment centres in England, the researchers
analysed the drug use, CD4 count and HIV RNA load of 16,593 patients.
They found that over a seven-year period the median CD4 count and HIV
RNA burden changed from 270 cells/mm3 and 4.34log10 copies/ml, to 408
cells/mm3 and 1.89log10 copies/ml. They say that this improvement may
reflect the recent increase in the number of new drugs available on the
market and a better understanding on the patient’s part of the
need for adherence despite side effects.
However, they also recorded the proportion of patients who had failed
to or ceased to respond to a regimen containing a protease inhibitor,
a non-nucleoside reverse transcriptase inhibitor or a regimen containing
both.
At seven years of follow up, 38 per cent of patients had used all three
drug combinations, and of these about a quarter had evidence of viral
failure with all three options. These patients were more likely to have
a higher HIV RNA burden and a lower CD4 count. It is these patients,
exhibiting poorer immunological and virological status, whom the researchers
say are in danger of exhausting their options for future treatment. They
say that these patients need new drugs with low toxicity that are not
associated with cross-resistance.
The paper was published early online on BMJ First |
The
Pharmaceutical Journal
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