More than 25
years into the AIDS epidemic, many drugs are used to treat
HIV, but an alarming number of patients are becoming
resistant to therapy, driving research into new ways
to combat the virus.
clinical trials of several promising new products will be
unveiled at a conference of leading HIV researchers in Los
Angeles next week.
"There is a
confluence of new drugs in the pipeline that people are
pretty excited about," said Anthony Fauci, director of the
National Institute of Allergy and Infectious Diseases.
next-generation versions of longstanding HIV fighters as
well as drugs that combat the virus through innovative
mechanisms, including blocking it from entering
immunodeficiency virus that causes AIDS infects more than 1
million people in the United States and nearly 40 million
worldwide. An estimated 40,000 Americans become
infected each year.
About half of
U.S. patients treated for infections with HIV have stopped
responding to at least one drug, said John Mellors, chief of
infectious diseases at the University of Pittsburgh.
becoming a problem because the virus can mutate,
particularly if patients fail to rigorously follow
complicated drug regimens.
On Tuesday, Merck
will release results of a trial of MK-0518, which is
likely to be the first in a new class of drugs, known as
integrase inhibitors, designed to block genetic
information needed for HIV to reproduce. Merck plans
to seek U.S. approval for the drug in the second
"It looks like a
very exciting result," said Mellors. He said
clinicians are starting to see response rates in patients
previously heavily treated for HIV that are similar to
effectiveness seen among first-time patients.
Gilead Sciences, maker of top-selling HIV pill Truvada,
will present data from a midstage trial of its experimental
integrase inhibitor GS-9137.
Bischofberger, head of research for Gilead, said comparisons
with Merck's data would be problematic because
patients in the Gilead study were not allowed to use
other therapies until the company obtained information
on potential drug interactions.
About four months
into the six-month Gilead study, patients were allowed
to use protease inhibitors, a commonly used family of HIV
drugs, he said.
new class of medicines works by blocking HIV from
entering and taking up residence in T cells, a type of white
blood cell vital to the immune system.
The drugs work by
jamming receptors--or docking stations--that dot
the surface of the T cells and act as doorways into
the cells. If HIV is barred entry, the virus cannot
receptors are made of a protein called CCR5, the crop of
drugs are called CCR5 inhibitors.
Pfizer will present data from a late-stage trial of its CCR5
inhibitor maraviroc, now awaiting U.S. and European
approval. Patients in the trial had fared poorly on
previous HIV treatments.
"If maraviroc is
approved, it would change the landscape of treatment
and be the first new oral class of HIV treatments in a
decade, since the approval of protease inhibitors,"
said Howard Mayer, a Pfizer executive in charge of
inhibitors do not attack the virus itself, as all four
existing classes of HIV treatments do, Mayer said HIV might
be less able to come up with ways of resisting their
Johnson & Johnson, which last year launched its first
AIDS drug, Prezista, will announce results from a midstage
trial of its next-generation nonnucleoside reverse
transcriptase inhibitor, known as TMC278, which works
by blocking an enzyme the HIV virus needs to
Conference on Retroviruses and Opportunistic Infections will
be held at the Los Angeles Convention Center. (Deena
Beasley and Ransdell Pierson, Reuters)
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