ANTI-HIV DRUGS REACHING LIMIT COMPLICATIONS INCREASING IN
By Steve Sternberg
USA Today 7 February 2001
Chicago -- People with advanced AIDS who were started on anti-HIV drugs in
1996 have now begun to reach the limit of the drugs' effectiveness -- and
they are running out of time, says research out Tuesday.
Doctors blame mounting drug resistance and longstanding damage to the
patients' immune systems for the drugs' waning benefit. "At some centers we
are beginning to see AIDS and AIDS-related complications," says Steven
Deeks of the University of California-San Francisco.
These drug failures have not yet occurred in enough people to appear
in national statistics, Deeks says, but that will eventually change unless
new classes of drugs can be developed.
David Ho of the Aaron Diamond AIDS Research Center in New York says new
drugs are on the way, but they may not arrive in time to save people who
began therapy in 1996. He cited one drug in particular, TMC126, that
appears "particularly potent," but it has not yet been tested in humans.
Current medicines, prescribed in multidrug cocktails known as Highly
Active Anti-Retroviral Therapy (HAART), cripple HIV, the AIDS virus, so
that it can no longer replicate. But HIV has proved to be a wily adversary
that mutates quickly and becomes resistant to the most potent drug
In a study of 300 patients who began treatment in 1996 with advanced
disease, one in five have developed AIDS again or died over the past five
years, Deeks reported at the Eighth Annual Retrovirus Conference here.
Many initially experienced "miraculous" responses to therapy, he says.
Deeks blames mounting drug resistance for the failures. Three studies
presented Tuesday from the USA, Switzerland and France indicate that about
10% of people in those countries are initially infected with drug-resistant
Some doctors now advocate testing patients for resistant HIV strains.
"People who are newly infected with resistant viruses are more difficult to
treat," says Susan Little of the University of California-San Diego, leader
of the U.S. study.
In a separate study out Tuesday, Michael Saag of the University of
Alabama-Birmingham found that the health of a person's immune system when
he started HAART also affects survival.
Doctors measure the potency of a person's defenses by counting T-helper
cells, white blood cells that govern the immune response. More than one
third of 380 people who started HAART in 1996 with a T-cell count of less
than 200 per cubic milliliter of blood died within four years, compared
with about 7% of those with higher counts. Overall, 73 of the patients have