July 8, 2002
Researcher Calls for Less Toxic HIV Therapy
BARCELONA— A Northwestern University researcher today called on HIV researchers and clinicians to develop more simplified and less toxic strategies to insure patient compliance and quality of life without sacrificing the potency of a protease inhibitor-containing regimen.
The current standard of care for HIV includes complicated protease inhibitor-based combination therapies with large numbers of pills and raises problems relative to drug potency, adherence, toxicity, resistance, and cost, said Robert L. Murphy, MD, at a symposium held at the XIV International AIDS Conference. Dr. Murphy is professor of medicine at The Feinberg School of Medicine and director of HIV/AIDS clinical research at Northwestern.
“Protease inhibitor-based therapies, although potent and effective, have been associated with complex regimens with dosing schedule restraints and frequent adverse events that may interfere with a patient’s compliance and quality of life,” he said.
Side effects reported with most currently available protease inhibitors include gastrointestinal effects, liver problems, and high levels of cholesterol and triglycerides in the blood. Protease inhibitor resistance involves the inability of the drug to retain sensitivity to other protease inhibitor-resistant virus.
“There is increasing concern that failure of the initial protease inhibitor-containing regimen will jeopardize the opportunities for patients to successfully respond to subsequent protease inhibitor therapy due to the emergence of cross-resistant virus,” Dr. Murphy said.
“Each of these factors contributes to the likelihood that a patient will not be able to tolerate or adhere to therapy,” Dr. Murphy said.
Murphy discussed potential new HIV treatments, particularly atazanavir, a single-daily-dose protease inhibitor currently undergoing clinical trials, that has been found to be well tolerated and causes virtually none of the negative effects on cholesterol and triglyeride levels associated with other protease inhibitors.