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New Selection of Simpler Drugs Encourages AIDS Researchers

By Thomas H. Maugh II

AIDS continues to be a devastating disease, but according to researchers, the prospects of fighting it have never looked better.

Less-complicated drug regimens are improving patients’ adherence to treatment, and the array of medications now available continues to reduce the death rate despite problems of drug resistance, scientists at the 10th Conference on Retroviruses and Opportunistic Infections said here last week. Several newer and potentially more effective drugs are now in clinical trials, and another dozen or so promising prospects are poised to begin such trials.

“This is an exciting, important year for therapy,” said Dr. John Mellors of the University of Pittsburgh. “The pipeline is fuller than it has been for a long time.”

“It’s quite remarkable,” added Dr. Kevin DeCock of the U.S. Centers for Disease Control and Prevention. “You have to wonder what the end of the story will be.”

There are now 16 drugs approved to treat the human immunodeficiency virus -- many of them more powerful and longer-lasting than the earliest therapies.

As a consequence, many patients now are able to take two or three pills once per day, or even one pill twice daily, Mellors said.

“That’s a fantastic development” that makes HIV therapy more like treating hypertension and other more common diseases, he added.

And the ease is improving adherence to drug regimens. A few years ago, only 50 percent to 60 percent of patients took all their pills. “Now the proportion is up to 75 percent to 80 percent,” Mellors said.

Those results are reflected in survival. Amanda Mocroft of the Royal Free and University College Medical School in London and her colleagues studied 9,803 people diagnosed with HIV in Europe between 1994 -- just before cocktails of anti-AIDS drugs became available -- and 2002.

She reported at the retrovirus conference that the risk of either developing AIDS or of dying from it had fallen 80 percent by 1998. Since then, those risks have been reduced even further.