New Weapons Against HIV

As the AIDS pandemic enters its third decade, viral resistance is beginning to counter the success of "highly active antiretroviral treatment" (HAART), the multidrug cocktails introduced in 1996. "Viral resistance is a significant problem, particularly for patients who began therapy in the pre-protease inhibitor era and who developed resistance to multiple reverse transcriptase inhibitors," says Robert Schooley, a professor of infectious diseases at the University of Colorado Health Sciences Cen

Written byRicki Lewis

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According to the World Health Organization, at least 42 million people worldwide are HIV positive, and each day, 16,000 more become infected. Viral resistance, an inevitability of molecular evolution, arises when treatments do not totally suppress replication, so that variants can flourish. "HIV so far has been able to resist anything. There are so many viral variants that the chance that one can overcome a specific inhibition is certainly there," explains Dani Bolognesi, chief executive officer of Trimeris Corp. of Durham, N.C. "We now combine a number of different inhibitors that operate under different mechanisms so the chance that HIV replicates and spawns a variant that is resistant to all are low,"

A mathematical model based on the rate of increase of drug-resistant HIV infections in San Francisco predicts that by 2005, 42 percent of the city's cases will be resistant.1 The study also revealed that resistance arises more often ...

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