New government guidelines recommend against starting AIDS patients on a popular treatment combination, due to concerns that using two similar drugs can rapidly lead to treatment-resistant strains of HIV.
The Department of Health and Human Services is urging newly diagnosed patients to forgo therapies that specifically combine Videx and Viread with so-called "non-nuke" drugs like Sustiva. The regimen is one of several treatment groupings that have led to the dramatic turn around against AIDS.
Yet patients must swallow a litany of pills to keep the virus under control, and Videx and Viread, with their need to be taken just once a day, are a lot simpler to use. Dr. Roy Gulick, an HIV specialist who helped establish the new guidelines, said that the concerns about the combination should supersede their appeal.
"This has been an attractive option," said Gulick, an associate professor at Weil Medical College of Cornell University in New York. "But there's a high failure rate."
Recent studies show that HIV quickly grows resistant to the drugs when all three are used at once, possibly because Videx and Viread attack the disease in a like-minded fashion.
"When you use two similar drugs together, they tend to mimic each other and fail," he said.
Despite falling short initially, Gulick said that the combination could still be used if other options prove unsuccessful. Indeed, just about anyone is at risk for failing a specific type of therapy. The new guidelines reflect the broad choice in AIDS treatment, listing the pros and cons for each, while suggesting that doctors and patients pick a regimen that best fits their needs.
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There are currently more than 20 HIV drugs that fall under four broad categories, with an almost infinite number of combinations. Gulick said that that best regimens are those that attack the disease from different angles.
