Triple combinations: present and future
Article Abstract:
Combination drug therapy using at least three different drugs seems to be the most effective treatment strategy for patients with HIV infection. Treating HIV infection with a single medication will quickly produce drug resistance, due to the high variability and high output of viral mutants. Drug combinations are thought to reduce viral diversification, prevent the production of resistant strains, and lower the viral burden in general. Two-drug combinations have shown less promise than triple-drug combinations, involving the use of zalcitabine, nevirapine, and zidovudine. Triple-drug therapy appears to block virus replication much more completely than dual drug regimens. However, selecting appropriate drugs for combination therapy from the vast array of available agents is difficult. Patients may be reluctant to take several pills at various times of the day, especially if they feel comfortable taking just one drug.
Publication Name: Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
Subject: Health
ISSN: 1077-9450
Year: 1995
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Viral resistance and the selection of antiretroviral combinations
Article Abstract:
Careful selection of antiretroviral combinations in the treatment of HIV infection should reduce the risk of cross-resistance. Nucleoside and non-nucleoside analogue reverse transcriptase (RT) inhibitors are already available or under investigation, while protease inhibitors are a new class of drugs in the testing phase. Resistance to antiretroviral drugs taken alone may develop within days, weeks, or a few months. In vitro studies have determined the most effective drug combinations with zidovudine (AZT), an ideal candidate because there is no cross-resistance with other drugs. Both 3TC and AZT reverse viral resistance by switching status from AZT-resistant virus to 3TC-resistant virus, a promising drug combination according to preliminary clinical results. Drug tolerance and toxic side effects must also be evaluated on a case-to-case basis.
Publication Name: Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
Subject: Health
ISSN: 1077-9450
Year: 1995
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Measuring viral load in the clinical setting
Article Abstract:
Viral load changes in HIV-1-infected blood can be a measure of the effectiveness of antiretroviral drug combinations. In addition to quantitative competitive polymerase chain reaction, three other procedures are commercially available, including the nucleic acid sequence-based amplification (NASBA) system, branched-chain DNA, and the Amplicor microwell plate method. These quantitative approaches to measuring viral RNA load have been instrumental in pinpointing effective drug combinations with AZT, compared to monotherapy. AZT/3TC drug combinations produced the most pronounced RNA reductions associated with increased CD4 counts and decreased viral loads, suggesting disease stability. This effect was greater and remained so for longer periods of time than monotherapy with AZT.
Publication Name: Journal of Acquired Immune Deficiency Syndromes and Human Retrovirology
Subject: Health
ISSN: 1077-9450
Year: 1995
User Contributions:
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