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HIV/AIDS conference brought
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MOTHIRS I
Speak to Your Brothers is a
program of Cascade AIDS Project
ou (vorÁ J) a rd to yet io ide top
so you can enjoy
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Locations Jp
by Inga Sorensen
ly to be submitted to the Food and Drug
Administration later this year for full market
approval. Abacavir (1592) is a nucleoside ana­
logue from Glaxo Wellcome whose resistance
pattern is still being determined. About 3 per­
cent of people in trials are sensitive to the drug
and must discontinue use. Restarting treatment
has led to death.
DuPont Merck’s non-nucleoside reverse
transcriptase inhibitor Sustiva (efavirenz or
DMP 266) seems potent and easy to use.
Preveon (adefovir dipivoxil or bis-POM
PMEA) is a nucleotide analogue from Gilead
that shows modest activity in monotherapy but
may be more useful in combination and may
have a different resistance profile.
Amprenavir (141W94) is Glaxo’s new pro­
tease inhibitor. It is a small molecule that
should cross the blood/brain barrier. Its effec-
tiveness in comparison with other protease
inhibitors is not known, nor is its cross resis­
tance.
Hydroxyurea, PMPA, FTC, zinc fingers—all
are drugs or approaches that hold great excite­
ment for many researchers. But it is a lot like
the rush of a new love interest: Will it last? Is
esearcher David Ho’s theory of eradication
there a solid foundation for long-term results?
of HIV from the body garnered him star
status, including being featured on the cover of Hydroxyurea is the current darling of many
Time magazine. His initial
calculation of eradication
in as few as three years,
however, has been pushed
back to perhaps 20 years,
due to an accumulation of
new knowledge. In fact,
many scientists speculate
that the goal of eradica­
tion is an impossible one
and believe the focus
should be on helping the
body contain HIV at tol­
erable levels.
There is a greater
understanding now of the
sanctuaries where HIV
resides. In a paper pub­
lished last fall, Johns
Hopkins researcher Dr.
Robert Siliciano showed
the presence of HIV in
resting cells that lie dor­
mant for years. Current Dr. Roger Pomerantz
medications act against
activists because of tantalizing data on both
HIV only during its stages of replication, so
effectiveness and a non-resistant profile, but
these dormant cells may continuously drip
also because it is inexpensive and comes from
active HIV into the body as they reactivate,
the fringes of the research establishment.
necessitating continued therapy.
Dr. Franco Lori is studying the drug in com­
Dr. Roger Pomerantz of Thomas Jefferson
bination with ddl and d4T at Georgetown
University explained how various tissues may
University and sites in Europe.
create micro-environments in which HIV
evolves under differing conditions. Some drugs
He claims to have reduced HIV to unde­
have difficulty penetrating the blood barriers to
tectable levels (below 500 copies) in 24
the brain, eyes and testes. Other localized
patients. Reports from France indicate that two
enzymes may also pressure the virus differently.
people who went off the therapy a year ago
One activist called this information "gently
have maintained viral loads below detectable
tapping nails into the coffin of Ho’s theory of
levels.
eradication.”
But Lori cautioned his work is preliminary.
“Dosage is very important; we have to work out
s for therapy, Boston researcher Dr. Scott
this part,” he said.
Hammer said: “The holy grail is a drug
■ Conference resources available online include
with a high degree of potency, a minimal side
effect profile, absence of cross resistance to cur­
abstracts on the OFFICIAL CONFERENCE W eb SITE
(www.retroconference.org/) and summaries of
rent drugs, antiviral synergy with other agents,
major
presentations from PROJECT INFORM, a
the ability to penetrate cellular and body com­
patient education and advocacy group (www.pro-
partments, ease of use, and low cost. No drug on
jinf.org/RetrConf/
).
the horizon meets all of these criteria.”
Much of the buzz has been about drugs like-
he
5 th
Conference
on
Retroviruses and Opportunistic
Infections focused on “the drudge
work—making drug regimens
work in the real world,” said
Spencer Cox. “It is a lot of little adjustments
that will hopefully add up to easier, safer, cheap­
er regimens.”
Many participants agreed with Cox, who is
spokesman for the Treatment Action Group, a
New York AIDS activist research think tank.
There were no breakthrough announcements,
either positive or negative, during the world’s
foremost scientific gathering on HIV, which
drew 3,500 participants to Chicago, Feb. 1-5.
Dr. Douglas Richman, chair of the event
and a researcher at the University of California
at San Diego, says nearly 1,300 abstracts were
submitted.
Fewer than half were selected for presenta­
tion, which prompted some activists to grumble
about who was doing the selecting and what
was being excluded. But it went no further—
there was plenty to keep everyone busy.
T
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