COMBINATION DRUG THERAPY FOR AIDS

Encouraging results for yet more drugs for AIDS patients were announced at the 11th International Conference on AIDS, held July 7-11, 1996, in Vancouver, British Columbia. Because the data are so new, only popular press reports of the research protocols, findings, and prognostications are yet available; such sources are reviewed here.

While optimism is broadly expressed, it is not universal. And three weeks after enthusiastic chronicling of this multiple drug therapy (Gorman(a)), Time magazine moved on to peddle hope for AIDS patients in just as strident terms through placental blood transfusions (Gorman(b)). Clearly, multiple drug therapy is one in a continuing eruption of medical developments, all of which appear to be palliatives, none of which, so far, appears to be a cure.

The theory of combining drugs to attack the human immuno-deficiency virus (HIV) that produces AIDS is based on the virus' ability to replicate and mutate quickly to strains that are not affected by the latest single drug in its environment. Use of multiple drugs simultaneously is simply an attempt to inactivate or destroy the hardy and versatile virus, no matter how it reacts genetically to protect itself from chemical warfare. Until recently, AZT was the (single) best known anti-HIV, anti-AIDS drug. AZT attacks a viral enzyme, but not the same one as the newest FDA-approved anti-HIV drugs--the protease

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to undetectable levels (Maugh, 1996, p. A8). Back in New York, but at SUNY at Stony Brook, Roy Steigbigel found that indinovir (alone, apparently, although possibly with AZT or one of its relatives) reduced HIV to undetectable levels in 70 volunteers for almost a year (Sternberg, 1996). The cocktails tried in all these reported studies are summarized in Table 1 below. Table 1 RESULTS OF DRUG COMBINATION THERAPY TO DATE Researcher or Doctor  Drugs Tried in Reported Cocktails       # Pat- ients  Length of Test Period  Reference    ATC  3TC  ddC  PIa1  PI2  PI3      Dr. M. Markowitz  x  x   x1    9  1 yr  Maugh 7/12/96   Dr. R. Gullick  x  x   x2    97  60 wks  Maugh 7/12/96   Dr. W. Cameron     x1  x3   ?  ?  Maugh 7/12/96   Dr. D. Ho  ?  ?   x1  x2  x3  12  1 yr  Waldholz 7/12/96   R. Steigbigel  ?  ?   x2    70  <1 yr  Sternberg 7/13/96   M. Salgos    x  x3    <1,000  <1 yr  Sternberg 7/13/96   aPI = Protease inhibitor. 1Ritonavir. 2Indinavir. 3Saquinavir. Reasons for Optimism Sternberg (1996) has included optimism in the title for his announcement of the new therapy: "AIDS opti
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Some common words found in the essay are:
Drug Therapy, British Columbia, PIs Tanouye,  , Infectious Diseases, Medical Center, Dr Ho, AIDS Vancouver, DaunoXome FDA, According Beim, Roy Steigbigel,   , sternberg 1996, drug therapy, maugh 1996,   dr,  dr, 7/12/96 , 7/12/96  , beim 1996,  maugh, x2 ,  maugh 7/12/96,  x2, maugh 7/12/96 ,
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