HIV Therapy Options Examined

Hopefully, the era of pessimism regarding HIV therapy is drawing to a close and moving towards a period of realism, said Ann Collier of the University of Washington, at a symposium on antiretroviral therapy at the 34th Interscience Conference on Antimicrobials and Chemotherapy.

In the USA, there are presently four nucleoside reverse transcriptase inhibitors licensed: Wellcome's Retrovir (zidovudine), Hoffmann-La Roche's Hivid (zalcitabine), and Bristol-Myers Squibb's Videx (didanosine) and Zerit (stavudine), although stavudine is still considered experimental in many countries. The therapy which has generated most interest from a clinical point of view, said Dr Collier, was the ACTG 076 study of zidovudine in the prevention of perinatal transmission of HIV from mother to baby (Marketletter February 28).

The results showed a decrease in perinatal transmission from 26% in the placebo group to 8% in the treated group. The safety profile was acceptable with no increase in congenital anomalies in the infants. As with many studies, she noted, questions were raised such as long-term safety and how to optimise access to therapy, not only in the developed world but also in developing countries.