E-drug: Antiretrovirals in developing countries (cont'd)
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There is little question that compliance is an issue both for
development of drug resistant HIV, and for success of a regimen in
the classic method of the use of cocktails. I might suggest however
that more and more evidence is compiling that there may be a
signficantly different way to use antivirals than we have been thus far
familiar with- specifically interrupted therapy models being developed
at Mass General Hospital in Massachusetts USA. There is also data
strongly suggesting that drug interruptions do NOT cause problems
with resistant strains but rather partial compliance and suboptimal
levels of drug. I am not sure where this discussion goes, although I
understand it. I would however point out the unfortunate fact of life
that it is in the USA that the vast majority of resistant and mosaic
viruses are being found passing. And this will be true no matter HOW
compliant the rest of the world is.
A suggestion: can we look at the various forms of interrupted therapy
models and also at the new concepts in regimens and do an education
campaign around the whole issue? I mean after all, to pass on a
resistant strain would imply unsafe behavior and perhaps we can link
the use of antivirals to a heightened concern about passing on strains?
I suspect the solutions will be different from group to group but I think
we can figure out some ways to minimize the danger. Maybe antivirals
should be given out with a training session and condoms
David Scondras
Search for a Cure
617 266 0735
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